Elderly residents found in their own faeces, a lack of food and no hot water.
The appalling conditions inspectors have found in some of Norfolk's care homes have put the industry in the spotlight.
Homes are given one of four ratings from 'outstanding' to 'inadequate' by the Care Quality Commission (CQC).
And last year Norfolk had the lowest level of care homes rated as 'good' in the country and the highest number rated as 'requires improvement' - the step above inadequate.
But owners hit with poor ratings often claim inspections are unfair and just show a snapshot.
It was a defence put up by John Dupuis, who runs Elsenham House in Cromer.
Elsenham House was put into special measures in November but Mr Dupuis said: 'We [previously] got good in all areas and nothing has changed.
'However what has changed is four years ago we were dealing with a CQC inspector and all of a sudden they sent an email round and said she had resigned.
'The new inspector came round and… does all her stuff but never asks any questions.'
Mr Dupuis claimed that instead of basing the inspection on what residents said, it was instead based on paperwork.
'We were concerned and when the report came out it did not reflect what we do here,' he said. 'We are at the coalface; these are people who are very unwell.'
But this was contested by the CQC who said inspections were much more than that.
A spokesman said: 'We visit services to assess how they are delivering care, speak to people receiving care, their relatives and the staff and management of the services.'
Elsenham House is a residential home for people with mental health or challenging behaviour problems.
In the CQC report inspectors said it was unclean, but Mr Dupuis said: 'Some of these residents go to the toilet and as a matter of course they wee next to the toilet bowl.
He said health and hygiene inspectors were called in but they thought the home was 'absolutely brilliant'.
'We are facing reality head on and I've asked many of these people who sit in offices please come and spent a day with us.
'I've been in this business for 15 years, I've seen all the promises and all the words, I can see the pressure coming from central government that filters down.
'It's devastating because we are here and we really care for these people.'
Steve Dorrington, a former councillor, has homes in Dereham, Watton, and Wells, and said it did not make sense how his three homes, which he said were run identically, could get different ratings - two good and one requires improvement.
'Everything has changed with the inspection,' he said. 'We got requires improvement. What's very unfair is it is six months until your next inspection. You're stuck with that even if you fix it the next day.'
'The number of requires improvement has gone up quite a lot. There are also little clusters of 'inadequates' and 'requires improvements' and I think that's impacted by how the doctors' surgeries perform too.
'If they are short of doctors, nurses and they don't come out to you, and you end up with a grade three pressure ulcer, you get marked down.
'The CQC are in a difficult position now because if they really go tough on the homes there will be nowhere left to take the residents.
'I don't have a problem with the system at all but what they need to consider is when they punish someone it's not necessarily the people who are going to benefit from it. I think a little bit more care and consideration.'
Manager at the 'outstanding' rated Meadow House in Swaffham Joanna Jankowska said she used to think inspections were all based on paperwork.
But after seeing an inspection carried out, she changed her mind.
She said: 'I strongly believe it's not just a snapshot, even if you're doing bad that day.'
'Paperwork proves what you've been doing, if you have not got that they're going to judge you on that day.'
Alison Charlesworth, manager at Ford Place Nursing Home in Thetford which is rated 'outstanding', dismissed claims that inspectors looked at a snapshot in one day, pointing to the folders of paperwork she kept which she provided to inspectors.
'I get the snapshot of the day thing, if things don't run like they're planned to, but it's not about the day. Everyone makes mistakes, but it's how you learn from them,' she said.
At Saxlingham Hall, on the outskirts of Norwich, even though manager Theresa Parfitt had earned an outstanding rating she did see problems with the system.
She said: 'I think it's very difficult in homes where there's a lot of dementia. I think there are a lot of care homes struggling, 'It's very difficult to meet the care needs with the funds they receive.'
A CQC spokesman added: 'As part of our inspection process, we also seek information from other organisations such as Clinical Commissioning Groups, Healthwatch and local authorities about the services being inspected.'
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