Half of care services in Scotland had vacancies by the end of last year as providers struggled to fill empty posts.
Staff shortages were the highest since the Care Inspectorate and Scottish Social Services Council (SSSC) began publishing the figures in 2017.
As of December 31 2022, 49% of care services had at least one vacancy - up 2% on the previous year.
This was significantly higher - at 79% - for care homes for older adults, and 70% for care at home services.
The picture also varied geographically, with care services in East Dunbartonshire and Edinburgh reporting that 60% and 59% of their care services respectively had at least one vacancy.
For Dundee, Clackmannanshire, and North Lanarkshire the figure was also higher than the national average, at 57%.
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The vacancy rate nationally had also climbed from 8.1% at the end of 2021 to 8.7% last year, but the shortages were particularly acute for nurse agency services, where nearly one in five posts (19.6%) were empty, and for care at home services where 12.2% of roles were unfilled.
Providers mostly blamed "too few applicants in general" for the vacancies, as well as too few applicants with experience or not enough suitably qualified applicants.
It comes amid warnings earlier this year from Scottish Care than one care home in Scotland was closing every week.
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The Scottish Government has pledged that social care workers will be paid at least £12 an hour from April 2024 in an effort to close a widening wage gap between the care sector and the NHS.
Maree Allison, acting chief executive of the SSSC said the report "shows the sector is experiencing more significant pressures than ever before".
She added: "More needs to be done to attract and retain a workforce that feels valued and respected for the high quality care and support that workers deliver.
"The report shows there are lots of job opportunities in care services and we are committed to promoting careers in care, supporting the need for fair work, terms and conditions and an effective workforce voice to help make care an attractive career choice."
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Jackie Irvine, chief executive of the Care Inspectorate, said: “The report highlights the extent of the current recruitment and retention challenges being faced by the sector at a time when services are experiencing continued pressure.
"Adult social care services are facing particular challenges with 76% of care homes for adults reporting vacancies, the highest since our reports began in 2017.
“We remain grateful for the dedication and commitment of our skilled and qualified workforce during a time that remains challenging, and welcome the recent proposed increase to care workers’ salaries as one measure to help support the workforce.”
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