A hospital is still inadequate overall and needs to make significant improvements, a damning report has revealed.

The Medway NHS Foundation Trust will remain in special measures after an inspection by Care Quality Commission inspectors over the summer.

In fact, inspectors were so concerned about patient safety in A&E at the time of the visit they demanded immediate changes.

Scroll down for audio

Chief inspector of hospitals, Prof Sir Mike Richards, said performance may have even deteriorated in some areas.

Now the new chief executive says the legacy of instability is over at Medway Hospital after inspectors questioned the ability of the previous leadership team.

The Care Quality Commission raised questions about the ability of the board to drive improvement following their latest inspection in August.

In the report, published today, inspectors said safety was not a sufficient priority, facilities were in a poor state of repair, staffing levels are insufficient and staff morale was in a poor state with frontline staff reporting a sense of “change fatigue” and “inconsistent leadership".

Chief executive Lesley Dwyer said: "I think we all recognise that Medway has a legacy of instability of leadership and hasn’t been able to improve as quickly it needs to for a long time.

"We in a very different position now, we have a leadership team that is in place, strengthened with new members who bring different skills, and who are able to create the challenge and scrutiny that we welcome."

At the time of the inspection, inspectors raised questions about the ability of the board to drive improvement, but Ms Dwyer said that since then all of the positions that are needed at board level have been filled. Only the finance director position remains vacant.

Although the trust has been rated good in terms of caring for patients, it was rated inadequate overall and inspectors recommended that it remains in special measures. The trust has now been in special measures for two-and-a-half years.

Ms Dwyer, who joined the trust three months before the inspection, said: "I accept the conclusions of the report and am sorry that we are currently falling short of what the people of Medway and Swale deserve. We know we need to improve the services we provide and are absolutely focused on doing just that. The trust has suffered from years of instability and poor leadership and governance. This cannot be remedied overnight."

Although they found there had been some improvement since the last inspection in 2014, staffing levels across the hospital were still too low to meet people’s needs, and the trust remained heavily reliant on the good will of staff to undertake extra shifts and temporary agency staff to ease the pressures.

Despite the overall findings, the report said the staff provided compassionate care and patients spoke positively about the staff and said that they considered that their privacy and dignity had been maintained in most cases.

"Clearly it is disappointing that overall progress at the hospital has not happened as quickly as everyone had hoped" Tracey Crouch, MP for Chatham and Aylesford

Professor Sir Mike Richards, the chief inspector of hospitals, said they have been kept fully aware of any action taken since the inspection but although immediate safety matters had been dealt with, he was not satisfied that underlying issues had been resolved.

"It is disappointing to report that performance may even have deteriorated in some areas, despite the support which has been offered to the trust up until now," he said.

“It is our shared view with Monitor that this situation must not be allowed to continue. It is clear that the trust cannot solve these important issues on its own, and will require continued support for the foreseeable future.

"We are now considering, along with partner agencies, the best option available in order to improve services rapidly for the local population."

On the wards, clinical areas were not clean and hygienic and some needed refurbishment, including in the imaging department where there is a risk of exposure to radiation as the wooden door frames are cracking under the weight of the protective lead doors.

Ben Gummer, Minister for Care Quality, said patients deserved the safest care possible.

He added: "I am extremely disappointed that they are still not getting this standard of care.

"This is despite the trust benefitting from the specialist support and expertise which the Special Measures programme confers on organisations.

“We will not tolerate sub-standard performance or leadership and will support Monitor to do what is necessary to give patients the service they rightly demand as soon as is practically possible. This has gone on for too long now.

"I expect to see immediate steps to rectify the very serious issues raised in this report.”

Tracey Crouch, MP for Chatham and Aylesford, said: “Clearly it is disappointing that overall progress at the hospital has not happened as quickly as everyone had hoped.

"It was recognised at the start that it was going to be extremely difficult to address the challenges that the Maritime faced but I am not sure anyone thought it would take as long.

“However this latest report does highlight some areas that should be celebrated such as progress in maternity and the compassionate care provided by the dedicated nurses and doctors.

"The hospital is now under new management and they should be given all the support to address the issues raised within this latest CQC report.”

The trust was consistently not meeting their two-week targets for patients suspected with cancer and there were delays in patients getting scans, which meant they had to wait too long for treatment.

Cllr Teresa Murray, Medway Labour group health spokeswoman, said: “I share the inevitable disappointment that staff will feel because they have worked hard in difficult circumstances to try and lift the hospital out of special measures.

“Medway Labour will be calling for clear milestones to better monitor the progress of the improvement plan and call on the Medway Council to play their part in supporting the hospital by investing in stronger community based care so that when vulnerable patients leave hospital they have secure care plans in place to prevent them from deteriorating again.”

Inspectors from the Care Quality Commission visited Medway Maritime Hospital in August 2015 and made further unannounced visits in September.

A Quality Summit is being held tomorrow where the trust and others health groups will discuss what needs to be done moving forward and what support the trust needs.

For further comment and analysis pick up tomorrow's Medway Messenger.