MarkTopps, manager of Little Wakering House, a care home for adults with learning difficulties and mental health needs, said: "Providers are really struggling. Recruitment is dire, all efforts are largely failing and then they are dealing with burnout and sickness. On top of that, home care providers are turning away clients as they don't have staff."

       A 16-week grace period started last Thursday and September 16 is the last date by which care home workers will have to have received their first jab so they are fully vaccinated by time new regulations come into force on November 11.

       But concern remains about the potential for unsafe staffing levels due to self-isolation and the dwindling number of workers in the sector.

       The Department of Health and Social Care estimates around 87 percent of the 570,000-strong care home workforce will have had both shots by the time the regulations come into force while seven percent will refuse.

       Vic Rayner, chief executive of the National Care Forum, warned of "very significant and potentially catastrophic challenges for the delivery of care" if the right level of guidance and support is unavailable.

       She added: "By their own assumption the Government has determined it is likely that seven percent of the workforce will not be deployable as a result of this policy.

       "The assessment claims this is likely to mean that 40,000 staff are unlikely to be able to work in care homes within the next 16-weeks.

       "In addition, the statement identifies an associated cost of ￡100million to recruit and train replacement staff. However, this assumption does not bear any reference to the costs of implementation of the policy itself."

       Ms Rayner added: "The announcement around pay increases for NHS staff can only serve to rub salt in the wound for care staff, many of whom will have received no increase at all this year."