Look closer at Norfolk and Suffolk care homes after the crisis of Southern Cross

There is a spotlight on the UK's care home providers and the glare is getting brighter every day.

Hovering on the brink of bankruptcy unable to pay its �230m a year rent bill, private provider Southern Cross has made the headlines for the wrong reasons this week.

The firm, which is responsible for 15 homes in Norfolk, four in Suffolk and seven in Cambridgeshire, was in dire straits on Monday, having decided the only way to survive was to axe 3,000 jobs and cut its rent payments. When Jamie Buchan, Southern Cross chief executive, told national media that if the company could not reach an agreement with its landlords the group was unlikely to continue to trade, alarm bells rang loud and clear.

Late on Wednesday the company, its landlords and lenders struck a deal to 'work towards a consensual solution' over the next four months. It is likely that many landlords will withdraw from the group, branching out independently and leaving Southern Cross – currently the UK's biggest care home provider – a much smaller operation.

For the hundreds of residents living in Southern Cross care homes across East Anglia, it was welcome news. But the crisis, even as it appeared to be subsiding, has prompted questions over the quality of care homes we entrust our relatives to.

Hilary MacDonald, chief executive of Age UK Norfolk, believes the issue has sparked a wider debate on care for older people.

She said: 'The difficulties being encountered by care home providers serve as a reminder of the need to develop a sustainable long term plan for the future funding of social care.

'The important issue here is the wellbeing of the residents. In the past we have worked closely with a number of older people living in these homes, providing them with advocacy support and seven of the county's Southern Cross homes are members of our Care Home Finder service.

'Thankfully, so far we have not received any concerns or requests from residents or relatives and are informed that staff and management are doing all that they can to provide support and reassurance.'

It was revealed last weekend that nearly 30pc of the Southern Cross residential homes in England had been served with improvement orders by the Care Quality Commission (CQC).

The watchdog confirmed that 164 out of 581 homes have got 'non-routine conditions' on their registration, but has declined to go into specifics or comment on whether any of the homes are in Norfolk or Suffolk.

Improvement orders are issued by CQC when homes breach standards from insufficient staff numbers, failing to help vulnerable patients when dressing or eating to incorrect storage of medicines or putting the health and safety of residents at risk.

Over the past three years CQC has carried out unannounced inspections at all 15 Southern Cross-run homes in Norfolk. Ten of them were rated as 'Good', three as 'Adequate', one as 'Poor', and one as 'Excellent'.

Diamond House in Downham Market, received a random inspection in April 2010 and was the only Norfolk home to be rated 'Poor'. The purpose-built home provides care for up to 42 older people, including those with dementia.

'On walking into the home there appeared to be no activities taking place and people were sitting, sleeping or wandering with very little to occupy themselves with,' declared an opening line of the report.

At the other end of the spectrum sat Woodlands Residential Home in Thetford.

The significantly smaller care home with room for eight adults with learning difficulties was rated 'Excellent' following a random inspection in May last year.

'The home has a team of staff who work well to enable the residents to have a full and active life,' read the report.

'They include the residents' families as much as possible with an example given of the relative who worked for months alongside staff to help with the integration of their family member into this residential home.'

In the six months to April 2011, the CQC reviewed 49 homes in the UK and found concerns in 26 of them. Nineteen reviews questioned staffing levels and 16 raised concerns about whether residents were protected from abuse.

Edith Pocock, chairman of the Norfolk and Norwich Pensioners Association, is a firm believer that society's attitude must change before conditions in care homes can improve.

The 86-year-old, of Wymondham, said: 'I think 99pc of people, if they were able to choose, would want to stay in their own home. You only have to think of yourself; would you like to be put in a care home? I know I don't.

'It is very difficult and, to be honest, I don't know the answer.'

Christine Futter, the new chief executive of Sheringham-based Norfolk and Suffolk Care Support, believes Southern Cross made a bad business decision prior to the recession, but it is not the first care home provider to find itself in financially muddy waters.

She said: 'We've seen closures in Norfolk where we've had no choice but to move residents from one home to another on a Friday afternoon. The Southern Cross near-closure has really highlighted an ongoing issue.

'People view residential care differently and it is often not until we're directly faced with a decision do we give it any thought. For people on the outside looking in – those without experience of care homes – it has really raised anxieties about putting relatives into homes.'

Harold Bodmer, director of Adult Social Services at Norfolk County Council, said: 'The standards across the county generally have considerably improved in recent years.

'There are some brilliant homes in this region. In a way it doesn't matter who owns them, it's the quality of care they are providing that matters.

'Our position is trying to encourage people not to get too anxious about this. We want to reassure residents and their relatives that we're not expecting to see massive care homes closures in Norfolk, or elsewhere in the UK for that matter.

'Whatever happens – if there are changes – there will not be overnight closures and we will have time to plan ahead.'