CARE for society's most vulnerable is at a tipping point and will require a cash injection of billions over the next decade to run services as they currently are, watchdogs have said.

Warning that social work services were no longer sustainable in their present format and amid soaring numbers of looked-after children, pensioners and wages costs, the Accounts Commission said the quality of care was at risk unless there was a prompt root and branch shake-up.

A new report also warns councils will need to find an extra £670m annually by 2020 to provide a range of care services to over 300,000 Scots residents.

The report comes a week after economic forecasters warned Scotland faces cuts of up to £1.6billion within five years, with spend on childcare, health and police set to plummet.

The Fraser of Allander Institute said ministers would have to make billions of pounds of cuts to some key public services, including local government, as the UK government continues to pursue its deficit reduction plans after the EU referendum.

Douglas Sinclair, chairman of the Accounts Commission, said: "A critical test for any civilised society is how it provides for the needs of its most vulnerable people. Councils have coped well in recent years but Scotland is now facing a watershed.

"Increasing pressures on social work and rising expectations of what it should deliver can only intensify. Now is the time for some frank discussions and hard choices. It is vital that people who use and provide services, and the wider public, are actively involved in that debate on future provision."

According to the report, just over 200,000 people work in social work and social care, around one in 13 people in employment in Scotland, with many working within the private and third sectors that councils commission services from.

But that figure is dwarfed by the estimated 759,000 unpaid carers aged 16 and over, 17 per cent of the adult population and with an estimated value of almost £11bn.

Those using the services, costing around range from tens of thousands of children classed as 'looked after' or on a protection register, adults with learning, sensory, or physical disabilities, people going through the criminal justice system or those with addiction problems and almost 100,000 people requiring homecare services or in care homes.

But despite the recent reorganisation of social work into new integrated joint boards with the NHS, finance pressures remain, with a further cut on top of the £500m from the Government to councils last year, costs of implementing the Living Wage and the numbers of looked after children rising by over a third since 2000.

At the same time, the watchdog warns, councils and the wider care sector is suffering skills and staff shortages such as with nurses in care homes and mental health officers.

The report states: "In 2016/17, councils’ total revenue funding, that is the funding used for day-today spending, will be five per cent lower than in 2015/16. This is a reduction of 11 per cent in real terms since 2010/11."

Cllr Peter Johnston, health and well-being spokesman for Scotland's largest group of councils, Cosla, said local government had "reached a tipping point".

He said: "Mitigating and managing cuts is no longer a sustainable approach to the challenges we face. Demographic change, increasingly complex demand for care and support, additional legislative requirements and national policy commitments like the Living Wage are impacting on budgets and social care provision right now and drive the cost of social services up by over £500m in the next four years."

Labour laid the blame for the pressures with the SNP Government.

Communities spokesman Alex Rowley said: “This expert report shows the human cost of the SNP cuts to councils. It says the funding model is unsustainable. The SNP need to wake up that they can’t continue to cut services that the poorest rely on the most."