Care home turned cost cutting 'into a game'

Swedish nursing home operator Carema Care urged staff to engage in games to see how much they could save on elderly residents' food, diapers, and protective gloves, according to employees.

• Sweden earmarks billions for elderly care boost (15 Dec 11)
• Social Democrats tighten stance on care profits (4 Dec 11)
• Carema admits flaws in patient's starvation death (3 Dec 11)

“When ten residents needed to eat, you bought food for six or seven,” an employee at the Carema-run Kastanjen care home in the north Stockholm suburb of Järfälla told the Dagens Nyheter (DN) newspaper.

The so-called “Carema Game” consisted of 16 “attitude cards” which included various claims, such as “The best idea for improvement is that I save hours and minutes".

A former employee told the newspaper that the point of the game was to allow managers to see how employees answered.

Employees' answers were then recorded in a log by divisional or operational managers.

“As a little competition every month, see which division has spent the least. Maybe give one another tips and suggestions at the same time,” read one personnel file from the Kastanjen care home.

Representatives from Carema claim that the game was simply “a tool to prompt discussions at the workplace” with a few “dramatically formulated” questions.

The company also explained that employees' responses were written down, but that they weren't logged “in a formal manner”.

Rather, the proposed solutions that came up during the course of the game were recorded in an “improvement log”.

But Carema employees tell a different story, characterizing the game as something that led to “indoctrination and fear” among staff.

In addition to ordering fewer meals than there were patients, care home staff also tore up napkins into four pieces in an effort to use resources more efficiently.

“It's shameful. These are adults and they get a tiny napkin. Nowhere else in society is this done,” said on employee.

Carema also urged care home staff to think carefully about whether or not they needed to use slightly more expensive vinyl gloves when attending to patients, or if they might be able to get by using cheaper, plastic gloves instead.

“We were only to use vinyl gloves if we were going to attend to an infected wound, like multi-resistent bacteria. Otherwise we used plastic gloves when we washed elderlies' behinds,” one employee told DN.

“They cost a few kronor less per package, but they rip easily and you can get feces on your hands. They are also scrape the elderly residents' buttocks.”

According to the minutes of one employee meeting reviewed by DN, employees were also encouraged to think twice before delivering medicine to patients in a plastic cup.

“Everything is only about saving, saving, saving,” one of the nursing home employees told DN.