Scottish Care, which represents almost 1000 care home, care at home, housing support and day care services for older people, surveyed its care home members on issues such as recruitment and retention of staff, payment of the Scottish Living Wage and the sustainability of services.

Almost four out of five homes (79%) said they are struggling to recruit nurses, while a quarter face recruitment problems for front line care staff and 35% struggle to find managers.

The potential impact of Brexit was highlighted as almost two thirds of homes (63%) recruit nurses from the European Union and around a quarter (44%) also recruit EU care staff.

More than three quarters (77%) of the homes have vacancies and one in five (21%) have “significantly increased” their use of agency nursing staff to fill gaps.

Average turnover of staff in the care homes surveyed is 22%, up from 17% in 2015.

More than one in four (42%) of care home services believe paying Scottish Living Wage of £8.45 an hour has made them less sustainable, mainly due to lack of funding.

Scottish Care chief executive officer Dr Donald Macaskill, said: “We are struggling to recruit new staff and hold on to existing staff. There is a shortage of nurses which is little short of scandalous. There is a wholly inadequate resourcing of initiatives such as the Scottish Living Wage. Put simply, care homes cannot continue to survive on the breadline.

“Discussions on reform are coming to a critical stage. I hope this research sharpens the minds of all involved to realise that unless we identify real positive actions which include an adequate funding of care homes, we will be in a state which will be irretrievable.

“There is at the moment a small number of care homes closing because they simply cannot survive. It is incumbent on government at local and national level to recognise the real dangers this sector faces today and to respond accordingly or within the year, we will be faced with a real emergency. We cannot continue to get care on the cheap.”

A total of 161 care homes responded to the survey, looking after an average of 9,327 residents each week.