Inspectors have criticised the standard of home care for hundreds of thousands of elderly people in England.
Time constraints demoralised carers and elderly people, the report said
The Commission for Social Care Inspection said many people found their carers too rushed, and there was little time to build trust.
It said the system of giving 15 minute slots of help, before the worker moved to the next individual, could be "undignified and unsafe".
The government said there had been improvements, but issues remained.
Home care covers services like help with washing, dressing, feeding or assistance in going to the toilet, but it does not cover nursing care.
'Rights and dignity'
Commission chair Dame Denise Platt said the report Time to Care? painted a "mixed picture" of the quality of care.
The report said councils should rethink the way services were offered, and give people more choice.
Dame Denise said: "It is critical that those who commission and provide home care services listen to what people say they want and value.
"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.
"At worst, it can also result in services that do not respect people's rights and dignity."
In England, anyone with assets over £20,500 has to pay for their own social care, but anyone under that threshold has their care paid for by the state.
The report said the number of people receiving council-funded home care fell from more than 500,000 homes in 1992 to 354,500 in 2005, despite a rise in the older population.
The CSCI also found that councils concentrated services on people with the most severe needs, meaning others missed out.
Inspectors also found home care was often beset with serious problems in recruiting, training and retaining quality staff.
Younger people were given little incentive to work in the care industry, with many finding better-paid jobs in their local supermarkets, the report said.
CSCI's Chief Inspector Paul Snell said since it started regulating the sector three years ago, home care services had improved, but "fundamental change" was still needed.
He said carers could be rushed and could be numerous, citing one case where a woman had had five different carers in 10 days.
"There are problems of recruiting, retaining and training good quality staff," he said.
Age Concern's director general, Gordon Lishman, said care at home was often what older people wanted, but local authorities must "provide the levels of services needed".
"At a time when the government is emphasising care services that enable older people to stay in their own homes, too many frail and vulnerable older people are being let down by under-pressure staff and over-stretched councils who are not providing the care they need," he said.
A Department of Health spokesman said: "There have been many changes for the better but there remain issues of poor quality and reliability that we have to get right in the delivery of home care services."