Boris Johnson has refused to apologise for "cowardly" comments that "too many" care homes did not properly follow procedures during the coronavirus pandemic.
Mr Johnson has been widely criticised for trying to shift the blame onto the care sector - but his spokesman refused to apologise for the comments.
Asked repeatedly if the PM wanted to acknowledge his clumsy wording, his official spokesman declined.
It comes after Mark Adams, chief executive of the charity Community Integrated Care, said on Tuesday that he was "unbelievably disappointed" to hear the Prime Minister blaming care workers.
He told BBC Radio 4's Today programme: "I think this - at best - was clumsy and cowardly, but, to be honest with you, if this is genuinely his view, I think we're almost entering a Kafkaesque alternative reality where the Government set the rules, we follow them, they don't like the results and they then deny setting the rules and blame the people that were trying to do their best.
"It is hugely frustrating."
The PM's comments came after he was asked what he made of NHS chief executive Sir Simon Stevens' desire to see plans to adequately fund the adult social care sector within a year.
Mr Johnson said: "One of the things the crisis has shown is we need to think about how we organise our social care package better and how we make sure we look after people better who are in social care.
"We discovered too many care homes didn't really follow the procedures in the way that they could have but we're learning lessons the whole time."
Mr Adams said while most people were in lockdown, 1.6 million "brave" social care workers were putting their own health and lives at risk by going to work to protect people's children, parents and grandparents.
He added: "And then to get the most senior man in the country turning round and blaming them on what has been an absolute travesty of leadership from the Government, I just think it is appalling."
Vic Rayner, executive director of the National Care Home Forum, told the BBC the suggestion that care home workers were not following procedures was "totally inappropriate" and "hugely insulting".
She added: "Care homes across the country were dealing with an extraordinary amount of different guidance that was coming out from Government on an almost daily basis.
"So for the suggestion that they were not following procedures as laid out is totally inappropriate and, frankly, hugely insulting."
But Business Secretary Alok Sharma said Mr Johnson had been pointing out that no-one had known what the correct procedures were.
"The Prime Minister is certainly not blaming care homes," the Cabinet minister told Today.
Speaking earlier on BBC Breakfast, Mr Sharma said: "What the Prime Minister was pointing out is nobody knew what the correct procedures were, because we know that the extent of the asymptomatic cases was not known at the time."
"We have done our best to put our arms around the care home sector," he added.
