An expert panel has proposed an ambitious series of reforms to prevent 'total collapse' in Northern Ireland's social care system.
Despite an annual spend exceeding £900 million on adult social care, which includes services such as residential, domiciliary and nursing home care, the review warned the system was "collapsing in slow motion".
The report, commissioned by the Department of Health, made 16 proposals to improve the system, including boosting pay for "undervalued" care workers.
Its authors suggested a 'living wage' be adopted as the present standard of low pay had contributed to a high turnover of workers.
"Care work is highly skilled," it read.
"To be good at it you need a high degree of emotional intelligence, negotiating skills, and kindness in spades.
"Yet we surround care workers in a mire of paperwork and suspicion.
"Care workers receive amongst the lowest wages in the labour market: in short, a low-paid, high-turnover and undervalued workforce is a poor way to ensure the quality of care we demand."
The report recommended a first step to recognising it as a professional workforce would be to introduce a 'living wage', defined by the government as an hourly rate of £7.50 for those aged 25 and older.
This, it is hoped, would enhance the sector's ability to "attract the best people".
The review noted that growing demand and a limited range of support measures meant the gap between demand and supply was growing.
It also said the existing system "fails to recognise changing needs and expectations".
It said: "In our view, the system is collapsing in slow motion. Maintaining the status quo is not an option. Nor is a piecemeal approach to reform."
Other recommendations the report yielded included putting the rights of family carers on a legal footing and devising a strategy to bring them into the heart of the transformation of adult care and support.
"The agenda we have set is ambitious, and we do not underestimate the challenge of delivering it, but it is a challenge which must be tackled if a total collapse of the system is to be avoided."
The Northern Ireland Association of Social Workers (NIASW) said its members were the bedrock of the health and social care system and provided invaluable support to the most vulnerable.
Carolyn Ewart, NIASW country manager, said there were extreme pressures in the system and the first step in showing leadership was calling for the necessary resources to be made available to ensure services are funded properly.
"This is vital if people who rely on social care, and their families, are to be provided the assistance they need to live independently and with dignity.
"Central to the delivery of high quality services is enabling staff to spend meaningful time with service users, paying heed to their emotional as well as their physical needs."
She said the report recognised the need for change.
"The needs of users of social care should be the top priority of all involved and we urgently require political leadership to take the tough decisions needed to deliver a social care system to be proud of."