People who receive care at home have described going two weeks without a shower, getting their evening meal at 3.30pm and receiving care from workers who are "unable to boil an egg" in a new report.
Staff coming at different times and even missing appointments have also been highlighted in the Healthwatch England report on home care.
People receive care at home for a number of reasons including getting help with day-to-day tasks such as washing, dressing and cooking or help taking their medication.
The Healthwatch report, drawn from experiences shared by more than 3,000 home care users, their families and staff, suggests that home care is "in a fragile state".
Across England there are more than 8,500 home care providers, collectively helping an estimated 673,000 people.
Yet Healthwatch identified a number of problems in various parts of the sector including; staff being unfamiliar with the needs of their clients as set out in the care plan, staff not having enough time to fulfil all their duties, the level of skill held by care workers and care packages being "designed to meet the needs of the service provider rather than the service user".
Issues identified to Healthwatch include:
- Healthwatch Redcar and Cleveland was told by one home care user: "Sometimes they give me a shower but they go over their time. Most of the time they haven't got the time to give me one so I go a couple of weeks without one and that is not right, I feel dirty."
- A woman in her 80s told Healthwatch Bradford her carers were unable to boil an egg or make the bed, while another said care workers needed to be taught "home care common sense".
- A relative told Healthwatch Halton: "I've tried to change my mum's teatime slot, many times, 3.30pm is not teatime."
- A family member of a home care user in the Isle of Wight said: "Sometimes you question the logic of getting someone dressed and breakfast at 11.30am and then providing lunch at 12.15pm."
- A care user in Barnet saying: "I am diabetic and sometimes carers are late or don't show up and that really affects my medications and insulin administration."
The report authors wrote: "It's clear that home care, like the social care sector as a whole, is in a fragile state."
They added: "Many of those who spoke about their experiences said they valued the dedication and experience of those sent to care for them.
"However, where carers lack experience and basic skills, such as being able to wash someone or make them breakfast; this can result in very poor care."
Healthwatch, the health and care consumer champion, stressed that most people had positive things to say about their domiciliary care - with many older people praising the service because it enables them to remain in their own home and to maintain as much independence as possible.
Neil Tester, deputy director of Healthwatch England, said: "We heard examples of compassionate care from dedicated staff, but people also talked about care that doesn't meet even basic standards.
"Given the challenges facing the social care sector, it is more important than ever that people's voices are heard.
"So if anyone has a story they want to share or an idea they think might help, I urge them to get involved and speak to their local Healthwatch."
Commenting on the report Izzi Seccombe, chairwoman of the Local Government Association's Community Wellbeing Board, said: "Councils are committed to driving up standards of care and work closely with local providers to try and continuously improve services for people who rely on home care.
"This report shows that while most people report that their services are good there is a need to improve services.
"The financial pressure facing services is having an impact and even the very best efforts of councils are not enough to avert the real and growing crisis we are facing in ensuring older people receive the care they deserve.
"The continuing under-funding of adult social care, the significant pressures of an ageing population and the National Living Wage, are combining to heap pressure on the home care provider market."
She added: "This study shows the strain providers are under, and emphasises the urgent need for a long-term, sustainable solution to the social care funding crisis.
"While the £2 billion announced in the Spring Budget for social care was a step in the right direction, it is only one-off funding and social care services still face an annual £2.3 billion funding gap by 2020."
A Department of Health spokesman said: "Everyone deserves access to high quality care, including those who receive it in their home.
"This is why we have introduced tougher inspections of care services to drive up standards, provided an additional £2 billion for adult social care, and have committed to consult on the future of social care to ensure sustainability in the long term."
Copyright (c) Press Association Ltd. 2017, All Rights Reserved. Picture (c) Joe Giddens / PA Wire.