Britain's most vulnerable people are seeing a different carer every week, making their developing health needs harder to track and leaving the home care system teetering on the brink, a review has revealed.
Lack of organisation and high staff turnover is leading to a massive crisis as the most vulnerable were becoming more and more neglected, the review led by former care and support minister Paul Burstow said.
Some care users were treated by 50 different members of staff in a year, and the service - designed to free-up beds by keeping people out of hospital - was "not working", according to the Key to Care report.
The report warns:
If home care is not in crisis yet, it soon will be. More people need care and there is less money to pay for it and not enough people willing to do the work.
Instead, home care should offer elderly people an alternative to residential placements and allow them to stay in their homes for longer.
But the examination of Britain's home care delivery identified how the service is "not realising its potential".
The Burstow report adds: "It is not working for older and disabled people who need help to live independently, and who often feel poorly served by an inflexible system that is defined by specific tasks and little continuity among care workers.
"It is not really working for councils, whose budgets are shrinking while needs are rising. It is increasingly not working for care providers who are competing on price and working from framework contracts that offer little predictability of work and revenue."
Acknowledging a significantly higher-than-average staff turnover than other professions, the report adds: "We are facing a recruitment crisis, with up to a million more staff needed over the coming decades and, without better investment."
Speaking on the release of the report, Mr Burstow said: "We must make care work a career of esteem, where a living wage is paid, staff are trained and recognised as valued key workers who contribute a huge amount to society. This will inevitably come at a price, but the cost of doing nothing will be even greater."