Councils have been urged to rethink the way they provide home care for the elderly amid fears that services are too rushed and not properly tailored to people's needs.
The first ever inspection of home care in the UK today finds that although there are high levels of satisfaction with state-funded services, many older people feel they do not the get the kind of attention they need.
The Commission for Social Care Inspection (CSCI) warns the "15-minute slot" model of service, where care workers are allotted only a short amount of time to help people get up, wash and dress before going to another appointment, is "undignified and unsafe".
It calls for a more "flexible and holistic" attitude to home services "that is more closely attuned to what people actually want and need". In particular, it notes many people are contributing financially to their care, and deserve more choice.
The main problem is that home care services are overstretched - although the healthcare white paper emphasised the importance of preventative care, extra funding for councils has yet to follow, the CSCI says. It also warns of difficulties recruiting new carers.
All this comes despite a fall in the number of households receiving help from 528,000 in 1992 to 354,000 last year - a fall that today's report says is down to the increased targeting of services at those most in need, which has left others to fall through the net.
"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," said commission chairwoman Denise Platt.
"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."
The Local Government Association (LGA), which represents councils, said there was "unquestionably" a need to transform home services, and to invest in prevention and low level support - but said the Treasury must provide the funds to do this.
"Councils want to provide more personalised services to give elderly people the care they both need and deserve," said David Rogers, chairman of the LGA's community well-being board.
"An increasingly ageing population and issues around central government funding means there is not enough money in the system."
He added: "Local authorities are doing everything they can to change the services people use for the better, and indeed the CSCI report highlights innovative schemes that have already been introduced."