A rapidly ageing population and a squeeze on local authority funding mean fewer old people now qualify for help to pay for assistance with washing, dressing and eating.

The annual report from the Commission for Social Care Inspection (CSCI) found that, despite a 3 per cent rise in the number of over-75s, there has been a fall in the number of elderly people receiving any services — from 867,000 in 2003 to 840,000 in 2006.

Those receiving funded care in their own homes has fallen from 479,000 in 1997 to 358,000 last year.

The Commission is particularly worried about the lack of help on offer when an older person fails to meet the increasingly strict eligibility criteria laid down by local authorities. In many cases families are not given any help to find private services, or are directed to local charities for advice.

“People who only five years ago qualified for council-arranged help are today excluded by the system and left to fend for themselves,” said Dame Denise Platt, chairman of the Commission.

“The poor experiences of people and their carers trying and failing to get sufficient help contrast starkly with those people who do qualify for council-arranged care. Many younger disabled people and frail older people are being "signposted' to voluntary services.

Many are forced to rely on help from family and informal arrangements which can break down at short notice. People unable to rely on families or friends and unable to pay for care services themselves are simply left to cope with everyday life, while some become virtually trapped in their own home.”

In response to the report, the Government has today begun a review into the criteria used by local authorities.

The CSCI report found that many town halls had moved to a system in which help is available only for cases judged as “substantial” or “critical” — with wide variations in how authorities interpreted such criteria. This could vary even within the same local authority, with different staff applying the rules differently.

Several other goverment reviews are also underway, on dementia care, end of life care and the role of unpaid carers. A Green Paper into the funding of social care is also promised.

People seeking help, and the families who often end up providing it, could be forgiven for greeting news of another government review with some scepticism. The thorny issue of who should pay for this fast growing bill has been the subject of several substantial government reviews in the past, including a Royal Commission set up by Tony Blair in 1998. Its recommendation that personal care should be free was rejected roundly then, confusingly, adopted in Scotland.

Campaigners believe that this time the government is getting the message and will act. Key to the political pressure are Britain's six million carers who look after elderly or disabled relatives. Millions more families are looking ahead to their parents' old age with dread, wondering how they will juggle their work commitments and bringing up their own children with looking after their mother and father, often living many hundreds of miles away.

Another recent report found no support at all for the hotchpotch of care provided by local authorities. People would be happy to pay for some care themselves, as long as the Government would guarantee some basic care for everyone, and more to the poorest.

That appears to be the way the Government is moving. Privately, ministers say they are unhappy that when it comes to residential care, for example, those with assets of less than £12,750 have everything paid for while those with more than £21,000 get nothing.

Progress may be slow. The vast sums involved mean that ministers will not rush into making expensive promises. Sweeping changes to the social care system may also run up against election planning. There is no timetable yet for the Green Paper and next year seems more likely than this. Any changes are likely to become manifesto pledges rather than pre-election legislation.

The Conservatives' social care committee, charged with forging a new policy, has not met since last spring.

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