Care homes across the UK - some of which have seen their energy bills "rise by 1,400%" - are facing permanent closure this winter if the government does not step in to help, a social care provider has told Prime Minister Liz Truss in a letter demanding fresh support.
Some care homes have seen yearly bills rocket from £5,000 to £70,000 "overnight", said Tony Stein, CEO of Healthcare Management Solutions, whose businesses are feeling the full force of price rises caused by Vladimir Putin's war in Ukraine, while household energy customers are set to be protected by the government's new £2,500 price freeze.
And it's not only the energy market bringing the care sector to its knees, Mr Stein says the industry is facing a "perfect storm of significantly higher costs, squeezed fees and a lack of staff".
In his letter to the PM, shared with ITV News, the CEO said: "There can be no doubt that without some drastic action ahead of October, many care homes in the UK will be forced to close due to rampant energy price increases."
Mr Stein, whose firm runs 60 care homes in the UK, said "radical reform" is needed so care homes can support their residents with dignity rather than "wondering how we are going to pay the energy bill to keep them warm".
He urged Ms Truss to use the health and social care levy to fund the sector more effectively, however the PM is planning to scrap the levy by reversing the recent 1.25% increase in National Insurance which was designed to raise the cash.
Ministers are planning to announce support for businesses this week and a mini-budget is expected on Friday, where new Chancellor Kwasi Kwarteng will set out how the government is going to provide support this winter, but Downing Street would not provide details until the announcements are made.
The prime minister, after being elected as Boris Johnson's replacement two weeks ago, revealed on 8 September she would protect domestic customers from the price cap rising to £3,549 a year in October, as it had been due to, by freezing the cap at £2,500.
She said at the time that businesses would get an "equivalent guarantee" on energy prices for six months and after that, "vulnerable" businesses - including pubs - would receive further support, however, firms have criticised a lack of detail.
Pub landlord Stephen Hey told ITV News: "Someone should make a release and let us know a little bit more so we can actually feel confident about the future."
He's seen his annual energy bills at his Wickenham Arms Hotel in Cleckheaton rise from £10,000 to £56,000 this year and is "extremely anxious" about the crisis facing his industry.
"Sleepless nights, frightened all day," he said when asked how worried he is, saying he'd be forced to increase the price of a pint of lager to £16 in order to stay open, if the government does not provide sufficient additional support.
Stephen Hey, pub landlord, tells ITV News he's having 'sleepless nights' over soaring costs
Social care is grappling with multiple crises. Mr Stein said the care sector also needs a "staffing crisis" to be resolved if care homes are to be able to carry on looking after residents.
In his letter, he said: "We simply do not have the people willing or qualified to work in care homes. We have found hiring from abroad is prohibitively expensive with our last calculation of cost for recruiting from overseas running to £9,000 plus per person."
He urged the government to streamline the process for recruiting from abroad, but added a long-term solution is needed in order to "develop a pipeline of homegrown nurses".
That would require, he said, additional funding going towards training for care staff in order to "alleviate the financial burden" which puts many people off working in the sector.
There are around 165,000 vacancies in the social care sector - according to health care experts, one in seven patients in hospitals in England are medically fit to be discharged but cannot be because of a lack of social care in the community.
On the "perfect storm" facing the care industry, CEO Mr Stein said: “There is only so long this can continue and I implore the prime minister to grasp the bull by the horns and instigate some radical reform.
“Social care could help alleviate pressure on the NHS by freeing up beds, reducing bed blocking which is a major cause of long waiting times. This is just one benefit – there are many including the ability to care for our older people with dignity, not wondering how we are going to pay the energy bill to keep them warm.”