Fears have been raised over the pressures on the care system as the National Audit Office warned that funding and staffing levels are not sustainable.

In a damning report the public spending watchdog said the lack of prestige associated with working in care, poor career progression and low pay meant the sector struggled to retain staff.

It said that the vacancy rate for registered nurses in care had more than doubled from 4.1 per cent in 2012-13 to 9 per cent in 2016-17, even as the total number of jobs dropped from 51,000 to 43,000 over the same period.

In some cases local authorities said nursing homes had re-registered as care homes because they could not recruit the necessary nurses.

One in three nurses working in care is aged over 55, the report added, prompting concerns that the staffing problems would get worse as current workers retired.

Nurses in the care sector earn on average £27,900 per year, more than £3,000 less than the average pay for a registered nurse working in the NHS.

The NAO said the Government had failed to demonstrate that the sector was sustainably funded and had not followed through on commitments to make working in care more attractive by offering better career development and training to staff.