Councils must rethink how they provide home care for Britain's ageing population, the national inspectors of social care warned today, in a report that said the "15 minute" model of home visits was outdated, unsafe and undignified.

In the first ever major study of domiciliary care services in England, the Commission for Social Care Inspection (CSCI) found that councils were unable to attract and retain staff because of poor pay and that both carers and the cared-for complained of being rushed, demoralised and unable to form meaningful relationships.

The "15 minute slot", in which a care worker is expected to visit a person, wash them and get them dressed and ready for the day, was identified as a symbol of a regime that will be unable to handle the growth of Britain's older population.

"This report paints a mixed picture of the quality of home care," said Dame Denise Platt, the chair of the CSCI. "It is critical that those who commission and provide home care services listen to what people say they want and value."

"Failure to listen to what people really need, and respond to this, results in missed opportunities to promote independence and to help people live full and rewarding lives. At worst, it can also result in services that do not respect people’s rights and dignity.

"As the numbers of older people grow, councils must reshape services to support people living at home with more personalised care. Doing more of the same will not be enough."

Despite the increasing size of Britain's older population, fewer people are receiving home care provided by their local council now than in the mid-1990s. In 1992, 500,000 households benefited from funded visits, in 2005, that number was 354,500. The report blamed tough eligibility thresholds for excluding thousands of people who would benefit from care.

Paul Snell, the CSCI’s chief inspector, said "fundamental change" was needed to provide more flexible and sensitive services for the elderly. Surveys of carers and pensioners alike described rushed visits that were drawn up with little consultation with or relevance to the person receiving the care.

Quoting from a forthcoming report for the Joseph Rowntree Foundation, the study said that home care visits paid little attention to the rest of the lives of the elderly:

"Social care services have tended to focus on personal services within the home. Yet changes to the environment – post offices closing, bus services changing, more expensive adult education classes, pavements that seem unsafe because of cyclists or closures of public lavatories – may mean that older people go out less, exercise less, socialise less and feel less good about themselves.

"There is strong evidence that people’s feelings about themselves and the worlds in which they live, affect their sense of well-being and quality of life, which in turn affects their health".

Weakening the home care sector is an inability to attract staff and to train and pay them properly. "Home care services also often have serious problems in recruiting, training and retaining good quality staff. Younger people find better wages working in their local supermarket, and have little incentive to work in the care industry," the CSCI said.

The charity, Age Concern, welcomed today's report and highlighted the failure of councils to provide care earlier, only offering expensive, intensive care once the health of an old person had declined.

"Too many frail and vulnerable older people are being let down by under-pressure staff and over-stretched councils who are not providing the care they need," said the charity's director general, Gordon Lishman.

"Less intensive, preventative services that help keep older people independent and healthy for longer are being withdrawn. This means some older people end up needing more expensive and more intensive care."

A Department of Health spokesman said: "There have been many changes for the better but there remain issues of poor quality and reliability that we have to get right in the delivery of home care services."

"We will continue to work closely with the Commission for Social Care Inspection (CSCI), local councils and health trusts to bring about the improvements in services that people need and deserve."

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