A home care worker has been criticised after saying "Ey up chuff nut" to a disabled man.
A relative of the man highlighted the carer's language as part of a report into home care in Sheffield.
Independent body Healthwatch said families wanted care workers to improve their communication skills, especially when looking after those with dementia.
The watchdog said firms needed to be clear on how they vetted and recruited employees.
The woman who complained about the term directed at her relative said it would be a beneficial if his care workers spoke to him differently.
She said: "First one carer said "Ey up chuff nut". I think she was trying to be friendly, but it was not a good start.
"Don't treat him as very childlike, singing nursery rhymes to him.
"They see you at the worst time in your life. For training, that is important - how to speak to people."
'Lack of knowledge'
The comments are part of a wide ranging report by Healthwatch, which has gathered the views and experiences of users of home care and relatives, says the Local Democracy Reporting Service.
It said families wanted to see more general dementia training and specialist training in other areas, such as physical disabilities, mental health and long-term health conditions such as diabetes.
One person said: "It is no good asking what they need from the shops because they don't know.
"My relative always says they want trifle, but this means the fridge is just full of trifle."
Healthwatch said in the report: "Families reported having a lack of knowledge about how care workers had been recruited and trained, and it was perceived that no relevant experience or qualifications are needed to be a care worker.
"It needs to be clear how the providers are vetting and employing staff."