A tale of two care support workers
16 October 2013 Last updated at 09:09 BST
The care industry is being held back by budget constraints, low pay and a resistance to improving quality, according to Association of Directors of Adult Social Services.
It is calling for standards to improve, but some care workers say their hands are tied by a system that simply does not allow them to do their jobs properly.
Breakfast's Jenny Hill met one woman who said she was expected to be "in two places at once" because of a practice known as call cramming. Her voice has been disguised in this video to protect her identity.
It is a very different story for those given the time to support their patients, such as Michelle Menns. She told the BBC that she was not under too much pressure at work, but that she did have fears for the future of the care industry.