Privacy is essential for dignity, and as such should be a basic right for all elderly people living in care homes. That is the position of Scottish ministers, the Care Commission, which regulates the care sector, and just about every right-thinking person in the country.

Yet more than 6000 people living in residential homes for the elderly in Scotland are still sharing a room, it was revealed yesterday.

Some are sharing with more than one person, some have no privacy screening in their shared rooms and others find they are more likely to be placed in a shared room because their care is publicly funded.

By the end of this year every elderly person in a care home is entitled, if they wish, to a single room with an en-suite bathroom.

That is a requirement of the National Care Standards, which are set by ministers - but it is one which, in many cases, will not be met.

"To have one's own room if one wants it is, we consider, a basic right," said Jacquie Roberts, chief executive of the Care Commission.

"We have to work hard with the sector to make sure everyone has the choice of a single room.

"I think there will still be challenges with some care homes, but we are pressing on this matter, it's one of our priorities.

"We will expect them to have an action plan in place, and if they aren't making, or planning to make the changes, we will move to enforcement."

The shortage of single, en-suite rooms is just one of many problems in care homes highlighted in the Care Commission's quality review report, published yesterday.

Since it was established in April 2002, the commission has been responsible for the regulation of more than 15,000 services which provide care in Scotland.

These fall into two broad categories: services for adults, including care homes for the elderly, day care for adults and care at home, including home helps; and services for children and young people, which includes fostering and adoption, childminding and secure accommodation.

The commission's review is based on the findings of more than 55,000 inspections and 5000 complaint investigations since April 2002.

It found that care homes for older people were "the most significant cause for concern".

They accounted for the most breaches of regulations, the most upheld complaints and were the subject of the most enforcements by the commission.

Last year, more than one in four care homes for older people had a complaint upheld against it and two-thirds failed to meet their legal obligations in some way.

In fact, more than half, or 57%, of all upheld complaints across the different sectors last year were against care homes for older people. Of the 792 complaints investigated in these homes, 76% were upheld or partially upheld.

The most common complaint was about general health and welfare, but a significant number related to poor staffing levels. Health and welfare complaints relate to issues such as the right to privacy, dignity, choice and safety.

Over the four years the commission has been inspecting homes, a correlation has been found between the size of a care home and the impact that has on the quality of services provided.

The larger a care home, the more likely it is to have a complaint upheld against it or an enforcement issued against it.

While the average size of a care home in Scotland is 39 places, they range from a home with just one resident to one with 240 places.

The commission found that the smaller care homes were more likely to provide a personal service tailored to the needs of an individual.

"It is of concern to me how difficult it is to deliver quality personal care in a large establishment, and we've got to be very careful we're not warehousing very vulnerable people, because they are all individuals in their own right who need personal care and attention," said Ms Roberts.

"The larger the place, the more challenging it is to deliver that personal care.

"I don't believe there is an optimum size. Everything depends on the staffing, management and resources and how the environment is organised - you can organise a large care home in to small units."

The report asserts that staff are "the single most valuable asset of any care home - and the most expensive".

Inspectors found that some care homes were not providing the minimum number of staff required to meet the needs of the people using the service.

The report said homes were failing to vary staffing levels when a resident's care needs changed or to meet the requirements people have at different times of the day and night.

Lindsay Scott, of Help the Aged Scotland, believes this is because of the economics underpinning the care home industry.

"Let's face it, care homes are businesses and don't operate purely from altruism," he said.

"If they can make cuts, they'll make them, because they are out to make money.

"This is why the bigger the care home, the less time is taken with people.

"A lot of the upheld complaints concern underqualified, untrained staff being employed simply because they are cheaper.

"But you can't concentrate everything on the business aspects. You have to ask yourself what is the raison d'etre of a home. It is to give care, and that should be the primary aim.

"Making it a successful business, you would think, would be easier if you did things properly."