The National Audit Office (NAO) has said the sector was struggling in particular to recruit nurses and senior staff to run services, causing the elderly and disabled to go without care.

This warning comes a few months before the government is set to publish a Green Paper with proposals to change the way care services work. The watchdog has said changes were desperately needed as there were concerns the extra £2bn being invested over the next three years would not have any substantial impact.

Low rates of pay were found to be the main reasons potential staff were found not to be attracted to the sector. Most of the 815,000 carers in the system were paid less then £7.50 an hour and a third were on zero-hour contracts. 6.6% of posts remain unfilled, with 28% of staff leaving their jobs each year.