Faeces under fingernails, weeks without baths and calls to emergency services for support - these are some of the damning observations made at our region's failing care homes.

However, just 3pc of the 329 care homes in Norfolk and Waveney are rated as inadequate while 19.6pc are rated as outstanding.

Of the 11 homes currently rated inadequate and placed in special measures by the Care Quality Commission (CQC), three are under review and at risk of losing contracts and closing down.

Norfolk County Council said there were significant challenges across the care industry but it vowed to provide thousands more care home beds in the next decade.

The vast majority of care homes, 236, are rated good while another 63 require improvement.

-Inadequate care homes

Dunsland, Paston Road, Mundesley

Wymondham & Attleborough Mercury: Dunsland care home in Mundesley has been rated inadequate by CQC. Picture: Stuart AndersonDunsland care home in Mundesley has been rated inadequate by CQC. Picture: Stuart Anderson (Image: Archant)

Inspectors said incontinence pads were not being thrown away properly to prevent infections spreading, as some were found in bedroom bins.

Bedrooms, ensuite bathrooms and shared bathroom facilities were not clean and the care home also had a one-star food hygiene rating, inspectors added in October 2019.

Managing director David Finch said he faced the option of closing down the service but decided against it, as it would have left residents without a home, some of whom have been there for decades. He said funding cuts had a huge impact on the home and described recruitment as a struggle, but he said improvements were being made.

He also criticised the CQC for being "inconsistent".

Ivy Court, Ivy Road, Norwich

During a visit in July 2019, inspectors said they saw two residents being physically restrained, despite the care home having a no restraint policy.

Wymondham & Attleborough Mercury: Ivy Court Care Home in Norwich has been rated inadequate by CQC. Picture: DENISE BRADLEYIvy Court Care Home in Norwich has been rated inadequate by CQC. Picture: DENISE BRADLEY (Image: Archant)

They said when residents refused their medicine there were often no further attempts by staff to offer them later.

Inspectors found one resident at high risk of falls did not have a risk assessment reviewed in three months, despite having three falls within that time.

The care home, which is under review, was previously rated good in 2018.

A spokesman from Ivy Court said: "We continue to work with all key stakeholders and have an ongoing plan in place to further develop and embed improvements."

Kingsgate Residential Home, North Street, Sheringham

A report following an inspection in March 2019 states there were incidents of a resident repeatedly wandering off and being found by members of the public or staff who passed them while in their car.

There were no risk assessments in place for residents who managed their own medicine and there were only two staff members on shift at night supporting 25 people, inspectors said.

Owner Ginny Taylor said: "It has been an extremely tough period for everyone since the report was published, and we'd like to thank everyone for their continued support and positive feedback.

"We are striving to improve the areas highlighted in the report."

Northfields, West Earlham, Norwich

Inspectors found only one staff member worked at night - one carer had to call emergency services to help a resident off the floor as they were unable to do this alone.

One staff member told inspectors that they were advised by management to not wake up one resident if they wet the bed during the night, as a lack of staff meant they could not be supported to the toilet.

Wymondham & Attleborough Mercury: Staff and residents at Ford Place Nursing Home in Thetford celebrating an outstanding CQC rating in 2019. Picture: Ian BurtStaff and residents at Ford Place Nursing Home in Thetford celebrating an outstanding CQC rating in 2019. Picture: Ian Burt (Image: Archant 2018)

The care home was rated inadequate in July last year but it was rated good in its previous inspection in 2016.

Care home provider FitzRoy said: "We work closely with the local authority to ensure that we provide a responsive service that meets the needs of the people we support.

"We have taken immediate action to ensure we are offering a safe and well-led service."

St Michael's Court, St Michaels Avenue, Aylsham

Inspectors said one resident at high risk of malnutrition had lost weight while another resident at high risk of pressure ulcers was taken to hospital after their symptoms "significantly" worsened.

A report following an inspection in September 2019 states one person had bruises on their legs and face which was most likely caused by a carer using poor moving and handling techniques.

Wymondham & Attleborough Mercury: St Michael's Court in Aylsham has been rated inadequate by CQC for the third time in ten months. Picture: Runwood HomesSt Michael's Court in Aylsham has been rated inadequate by CQC for the third time in ten months. Picture: Runwood Homes (Image: Archant)

The care home is now under review after being rated inadequate for the third time in ten months.

A spokesman from St Michael's Court said: "We can confirm that a robust action plan has been implemented since the last inspection and a very capable, skilled team of nursing and care staff have been recruited within the service and we are now ready for re-inspection by the regulator to demonstrate the improvements across our service.

"A skilled, professional and highly regarded nurse manager now leads our service with exceptional feedback from our residents, staff and visitors."

Walsham Grange, Bacton Road, North Walsham

Inspectors found staff members were pre-filling residents' records with times and details of care yet to be provided.

During the inspection in August last year, inspectors said one diabetic person was fed chocolate cake twice in one day, while one family member said their relative had faeces under their fingernails, which they had to ask staff to clean.

Wymondham & Attleborough Mercury: Chiswick House care home in Christchurch Road, Norwich was rated outstanding by CQC. Picture: James BassChiswick House care home in Christchurch Road, Norwich was rated outstanding by CQC. Picture: James Bass (Image: Archant Norfolk Photographic© 2008)

The care home was previously rated good in 2017.

Walsham Grange did not respond to a request for comment.

The Windmill Care Home, Main Road, Rollesby

Records showed some people were not getting baths or showers for as long as five weeks, a report stated following an inspection in August 2019.

One person who needed to be continuously supervised was found eating tissue while another resident who had asked for a drink did not get one until 90 minutes later, inspectors said.

The owners did not respond to a request for comment.

Wymondham & Attleborough Mercury: Badgers Wood Care Home in Drayton, was given an outstanding CQC rating. Picture: Jamie GarbuttBadgers Wood Care Home in Drayton, was given an outstanding CQC rating. Picture: Jamie Garbutt (Image: Jamie Garbutt)

Sunnyside, Damgate Lane, Martham

In August last year, inspectors found staff were not getting regular breaks on 12-hour shifts.

They said access to risk items were putting residents in harm, with one person repeatedly attempting to tie ligatures around their neck, a report states.

Another environmental risk was loose bricks in the garden which could be used as a weapon or to cause damage to property, inspectors added.

Sunnyside did not respond to a request for comment.

St Georges Care Home, St Georges Road, Beccles

Wymondham & Attleborough Mercury: Hassingham House care home, in Hingham, was rated 'outstanding by the Care Quality Commission in 2019. Pictured is manager Caroline Newman with staff. Photo: Hassingham HouseHassingham House care home, in Hingham, was rated 'outstanding by the Care Quality Commission in 2019. Pictured is manager Caroline Newman with staff. Photo: Hassingham House (Image: Hassingham House)

An inspector found one staff member spoon-feeding a resident without checking if they had swallowed their food between mouthfuls.

An October 2019 report states residents were being left unsupervised for long periods of time - one person almost hit their head on a table from falling asleep before an inspector intervened.

They also found four out of five mattresses were covered with urine stains, while another 23 mattress covers were also stained.

The care home did not respond to a request for comment.

Oak House, Victoria Road, Diss

A report states staff had called police to "numerous incidents" when dealing with residents with challenging behaviour.

Wymondham & Attleborough Mercury: Munhaven Care Home in Mundesley celebrating an outstanding rating by CQC with a party. Picture: Sonya DuncanMunhaven Care Home in Mundesley celebrating an outstanding rating by CQC with a party. Picture: Sonya Duncan

Some carers told inspectors in June 2019 that they were not confident with supporting people with their needs, which they felt outweighed what the service could provide.

Staff said the manager "had no appreciation of the level of aggression, some unprovoked, that they were expected to manage", the report states.

The care home did not respond to a request for comment.

St Nicholas Care Home, St Nicholas Place, Sheringham

When inspectors visited in May 2019 they found a cleaning schedule showed the lounges and bathrooms had not been cleaned for a week and what appeared to be faeces was on the side of one toilet.

The inspection report stated one person had not had their inconsistence pad changed for more than 12 hours.

Wymondham & Attleborough Mercury: Raj Sehgal, owner and managing director of Docking House. Picture: Docking HouseRaj Sehgal, owner and managing director of Docking House. Picture: Docking House (Image: Docking House)

A family member said they saw a resident eating a potato off the floor, pointing to the lack of staff supervising the lunchtime meal, inspectors said.

The care home is currently under review.

The owners did not respond to a request for comment.

-Outstanding care homes

CQC rated 19 care homes in Norfolk and Waveney as 'outstanding' last year, all of which have consistently scored top marks in safety and quality of care.

They are:

Wymondham & Attleborough Mercury: Nadra Ahmed OBE, chairman of the National Care Association. Photo: Archant LibraryNadra Ahmed OBE, chairman of the National Care Association. Photo: Archant Library (Image: Archant)

- Hassingham House Care Centre, Hingham

- Meadow House Nursing Home and Westfields, Swaffham

- Windmill House, Wymondham

- The Beeches, East Harling

- New Boundaries Group, Taverham

- Badgers Wood, Drayton

- Ford Place Nursing Home, Thetford

- Cascade (Charlton House), Chiswick House and Highwater House, Norwich

- Brandon Park Residential and Nursing Home, Brandon

- Kevlin House, North Walsham

- Holmwood Residential Home, Bungay

- Nightingale Lodge, Hunstanton

- Munhaven, Mundesley

- Ealing House Residential Care Home, Great Yarmouth

- Broadlands and Harleston House, Lowestoft

Hassingham House, in Hingham, near Wymondham, was praised by the CQC in March 2019 for the "exceptionally kind and responsive" care provided by staff, who "understood how to make people feel valued".

"They had a strong focus on reducing isolation, loneliness and promoting intergenerational connection," the inspection report states.

Centre manager Caroline Newman said the care home created good links with the community, who got involved in activities both at Hassingham House and in the village.

The CQC also gave a glowing review of Munhaven, in Mundesley, when it visited the care home in June last year.

Inspectors described staff as "extremely sensitive and compassionate" and said residents were "encouraged to have a voice".

Manager Alison Roberts said: "We work hard as a team, whatever our job role is, to support our residents and their families who remain an integral part of the individual's lives."

'Poor practice will not be tolerated'

A Norfolk County Council report on adult social care, published in July last year, states the county lost 173 care home beds in the 2018/19 financial year.

It cited one major challenge in the care sector as the high turnover of nurses.

The latest care home to lose its contract with the council is Cawston Lodge, which closed in November last year after just six months of opening.

As part of a £29m investment, the council said it would deliver 3,000 extra homes for older people by 2028.

A spokesman said: "We face significant challenges across the care market in the county - increasing demand, meeting people's care needs, provider quality and market sustainability are just some of the issues adult social care manages on a day-to-day basis.

"We have always encouraged providers to request support before they reach crisis point, however ongoing poor practice will not be tolerated by the county council or the CQC."

'Tarred with the same brush'

One care leader who has seen his care home go from 'requiring improvement' to 'good' in one inspection criticised the CQC for being too subjective.

"I'm all in favour of constantly improving standards in the industry, but the issue I have with CQC is it's very much perception-based," said Raj Sehgal, owner of Docking House, in Docking, near Hunstanton.

"What's good to one inspector may not be good to another, based on a day or two of viewing.

"Everything is tarred with the same brush and that's where it goes wrong - it's the one size fits all approach."

He said the care sector was being "brought to its knees" by a funding and staffing crisis - in one year, Docking House lost all but five of 38 new staff within a month.

He said Docking House now offered a competitive salary which had helped to retain staff and in turn improve standards.

But he said this has had a knock-on effect on their overall budget.

"In our region we are competing against the hospitality sector - seasonal work pays higher," Mr Sehgal said. "How can we entice people to join the care sector if we pay less than Tesco?"

This sentiment was shared by Nadra Ahmed OBE, chairman of the National Care Association.

She said: "Underinvestment in social care has left providers to pick up the subsidy for the state which is unsustainable."

The CQC was contacted for comment.