One in four social care staff are leaving the profession every year, a health charity has found.
A new briefing from the Health Foundation warned that the future social care workforce was at risk without urgent action to establish a sustainable strategy.
The report said the introduction of the National Living Wage had little impact on staff retention because pay also increased in other sectors.
Problems with retention have led to staff shortages and an increasing reliance on agency workers.
Anita Charlesworth, director of research and economics at the Health Foundation, said: ‘The high rate of staff voting with their feet and leaving social care jobs raises concerns about the sustainability of the service and its ability to ensure high quality care.
‘If pay restraint in the public sector continues to 2019/20, it will have been in place for almost a decade.
'It is a policy that is testing the resilience of the workforce and the ability of services to improve while maintaining standards of care.
‘If there is a significant reduction in EU health and care staff following the UK’s decision to leave the EU it could have major implications for the quality and availability of services.’