More than 4.3 million elderly people are at risk of being without care because of where they live, new research has suggested.
Just one in five local areas in the UK report having enough care for people aged 75 and over to meet demand, with a third (34%) of local authorities expecting the situation to get worse in the coming year.
Coram Family and Childcare Trust's annual Older People's Care Survey, sponsored by Legal & General, found significant variation in social care depending on region.
No local authorities in Inner London or Northern Ireland report having enough care to meet demand in their area, while almost half (44%) did in the East Midlands and the North East.
Only 1% of local authorities expect an improvement, the survey reports.
Following a series of Freedom of Information requests to local authorities, the charity found the average residential cost varies between region, with the average price for a week of residential care in inner London 32% more expensive than in the North West.
Local authorities pay £585 on average per week for all residential care types, a 5% rise since last year.
The research found that self-funders are likely to struggle with prices 13% higher than those paid by local authorities for residential care. Even if people funding their own care paid the same price as local authorities, at nearly £17 an hour, it will take just one year and one month to spend £20,000 of savings for 21 hours of support a week.
Older people who require care at home are also at risk, with only half of local authorities (51%) reporting enough in their area.
Megan Jarvie, head of Coram Family and Childcare, said: "High quality care for older people can help to improve their wellbeing and stay well for longer.
"But the gaps in care that we have found are likely to cause stress and hardship for older people and their families.
"Fixing our care system is an opportunity to support older people and their families to lead happier, healthier lives and to reduce the strain on the NHS."
Chris Knight, chief executive officer of Legal & General's retail retirement division, said: "We're all part of the ageing society and this brings both opportunities and challenges - that is why it is important to support the Government and the NHS to deliver a better long-term care system.
"At the moment there is too much confusion about how people find the right long-term care and how much people have to pay from their own pocket.
"We want to see a system of long-term care that is predictable and fair."
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