Low rates of pay and workload pressures mean care services can no longer fill key posts in England, a watchdog says.
The lack of government planning and funding has undermined the "Cinderella" service said The National Audit Office.
This warning comes as ministers draw up plans to overhaul the sector as its struggling to recruit nurses and senior staff. This is having an adverse effect on the elderly and disabled going without care.
A Green Paper with proposals to change the way care services was promised by the government that work will be published by the summer. This will cover care homes and support in the home for tasks such as washing and dressing paid for both by councils and privately by individuals.
Tammy Ardron, a nursing home nurse in South Yorkshire told the BBC, "When you are hospital based you have doctors at the end of the beep, somebody to call on. Here you are on your own…It is busy. You've got to be on the ball all the time."
With low rates of pay - most of the 815,000 carers in the system were paid less than £7.50 an hour and a third were on zero-hour contracts.
Across the sector, 6.6% of posts remained unfilled, with 28% of staff leaving their jobs each year - double the rate in the wider economy.
National Audit Office’s Chief Amyas Morse said: "Social care cannot continue as a Cinderella service - without a valued and rewarded workforce."
Caroline Abrahams, of Age UK, said the report was a "damning indictment of the failure of successive governments" and meant frail older people were going without the care they needed.
The Government said it is currently putting together a 10-year workforce strategy which would take a long-term look at the sustainability of the health and care sectors.
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