Successive governments have been “asleep at the wheel” on adult social care, says the head of the independent commission looking into the sector in England.

Baroness Louise Casey said care services for older people and adults with disabilities had been developed in a largely uncontrolled and unintended way, unlike the deliberate design of the NHS in 1948.

As a result, she suggested a postcode lottery had developed with different levels of services available depending on where people live.

And she also highlighted the fees that self-funders pay, saying they were much higher than councils were charged for people entitled to state support.

Baroness Casey said care services, such as home adaptations and personal care like helping people out of bed and with washing, were simply not valued enough.

Speaking to the BBC’s Today programme, she said the NHS had become a “national hospital service: that was focussed on medical care”.

And she said the failings identified by the recent Covid inquiry report into social care were testament to that.

Last month the inquiry published a report which said the care sector appeared to be “something of an afterthought” in the early stages of the pandemic, allowing Covid to spread like “wildfire”.

Baroness Casey, who will address a conference of social care leaders later on Wednesday, said the findings were “so awful” and “a national shame”.

“Successive governments have been asleep at the wheel. We’ve got our heads in the sand.”

Her final recommendations for services for older people and adults with disabilities, including care homes, will be published next summer.

It comes as her commission publishes research showing England is an international outlier for having no “clear system of stewardship” for social care, unlike countries such as France and Germany.

She said the market was dominated by private providers and said the regulator – the Care Quality Commission – as being a “spectator at the site of a car crash”.

The research found:

When Andy Burnham became prime minister, he said social care was one of his key priorities although the Casey commission was set up by the Starmer government.

“Together, we can build a new settlement for care,” Baroness Casey said.

“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.”