We received permission to conduct the study from the head of the division at the county council and from the heads of social welfare care in the 10 municipalities. The participants received written information about the study purpose and procedure, the voluntary nature of participation, and they were assured complete confidentiality and that the findings would only be presented at the group level. The national laws (SFS 2003:460) and guidelines were strictly followed. In accordance with Swedish requirements, ethical approval was not required because the study concerned the staff members’ work and, did not involve the participants’ health.