Many people are in denial about getting older and remain focused on “trying to keep young” which has left adult social care as a forgotten “Cinderella service”, the leader of a review into reform of the sector has said.

Baroness Louise Casey – who has accused successive governments of being “asleep at the wheel” on funding and provision over the years – said public knowledge of how social care works, including the fact it is not free at the point of use like the NHS, is “so low”.

Her independent commission into care, which is expected to report next summer, has published new research concluding adult social care is a “fundamentally fragmented system” with no-one in charge overall.

People with savings worth more than £23,250 are not entitled to help with the cost of care from their local council and high fees sometimes mean people are forced to sell their homes to pay for what they need.

In an interview with the Press Association, Baroness Casey said: “It’s not like we’re not already paying for social care, and in a way, we’re paying for failed social care.”

She welcomed Prime Minister Andy Burnham’s proposed changes to the pensions triple lock to pay towards a National Care Service as “a major win for social care”.

Mr Burnham announced in September that he would end the policy which guarantees increases to the state pension in line with inflation, earnings or 2.5%, according to whichever measure is highest.

Instead, it could rise in some years in “relative” value to earnings and it is hoped the measure will generate about £15 billion a year by the end of the 2030s.

In the aftermath of Mr Burnham’s address, the Institute for Fiscal Studies suggested savings would not be enough, but Baroness Casey told PA: “I felt that was a very significant win for adult social care, and particularly to develop a service for the people that I feel we’re not spending enough money on, we’re not delivering enough services to, which is a new service, really, an additional service for the frail and for the elderly.”

Asked why she thinks there is such a low level of awareness of how social care works and focus on the issue more generally, Baroness Casey said: “We must spend billions on trying to keep ourselves younger. I mean, let’s be honest about it.

“There’s a multimillion-pound industry of people trying to keep young, and so I think what’s interesting is I think we’re in denial about getting older, and therefore we don’t think things through. Because actually, you know, it’s not always easy.

“‘How do I live well? and how do I age well?’ has to be something that we have in our minds as we get older.”

She acknowledged her challenge, as the head of a review which will put forward recommendations for change to Government, is “huge” but insisted it is time to put social care “on the map”.

She told PA: “I think the time is right. I think that if we can start to get our heads around what social care actually is, then I think the public will start seeing what it is, and I think they’ll be supportive of wanting a better deal.

“This is an issue that affects every single family and every single individual in the country. If you’re alive and reading this, then at some point in your life you are going to get older.

“My thing here is let’s do this well, let’s do it with dignity, and let’s do it together. I think the time is right to do something about it and we appear to have kind of greater political consensus that we ought to be doing better on social care.”

In a speech in Liverpool on Wednesday, she will brand failings in the pandemic which saw Covid-19 “spread like wildfire” in care settings, where many older people died without family at their bedsides, “a national shame”.

A report by the UK Covid-19 Inquiry last month stated the care sector was “an afterthought” and rubbished then-health secretary Matt Hancock’s claim made in May 2020 about a so-called protective ring around care homes at the start of the pandemic as “unfounded”.

Inquiry chairwoman Baroness Heather Hallett said: “Quite the opposite was true.”

Baroness Casey, in a speech to a gathering of social care leaders at the National Children and Adult Services Conference (NCASC), will call for “a new settlement for care”.

She is expected to say: “Successive governments have been asleep at the wheel. In research we’re publishing today, the lack of ‘stewardship’ of social care comes through clearly. No-one is in charge.

“Together, we can build a new settlement for care. One based on values I still believe this country shares: decency, contribution and a duty to care for our neighbours, our loved ones and ourselves.”

A report, commissioned by Baroness Casey’s team and carried out by the Nuffield Trust and the Institute for Government think tanks, concluded adult social care in England is currently “a complex system where responsibilities are spread between central government departments and across a range of arm’s-length bodies; between national and local government; and between government and a vast array of non-public sector providers”.

The report points out that while more than 1.5 million social care staff work across around 19,000 employers, England is the only one of the UK’s four nations with no mandatory register of care workers.

The current make-up of the sector means private providers “dominate” in a pattern that has “emerged in a largely uncontrolled and unintended way”.

The report warned of “poor transparency” around fees paid to and charged by providers, with people who have to pay for their own care charged, on average, 40% more for the same service than people whose care is arranged by their council.

Elsewhere at the conference, working in and accessing social care was described as being like “a frog in a blender”.

Phil Holmes, president of the Association of Directors of Adult Social Services (Adass) which represents social care leaders, said: “Whether you are seeking support from adult social care or you work in it, you will spend lots of time being yanked around every which way while you try to reach out and land something that will make the right impact on your own life or the lives of others.”

He commended social care staff for the work they do “in spite of the ludicrous, distorting forces they are dealing with”.