The findings were made during an inspection of four services at Kettering General Hospital in December.

The overall rating for children and young people's services went up from inadequate to requires improvement. With safe and well-led improving from inadequate to requires improvement, effective and responsive again rated requires improvement, and caring again rated good.

Urgent and emergency care was once again rated requires improvement with safe remaining inadequate, effective, responsive and well-led once more requires improvement, and caring down from good to requires improvement.

Medical care was once again rated requires improvements with safe, effective and well-led still requires improvement, responsive down from good to requires improvement, and caring again good.

Surgery was once again requires improvement, with safe and responsive remaining requires improvement, effective and well-led were down from good to requires improvement, and caring again good.

Charlotte Rudge, CQC deputy director of operations in the Midlands, said a decline in leadership quality had impacted on the quality of services.

Demand pressures were found in urgent and emergency services with people found sitting on floors or standing due to lack of space.

Relatives had to alert nurses to people's deteriorating health in the waiting area which placed them at risk of harm.

The children's and adult's waiting rooms were not separated putting children at risk of trauma through witnessing high risk patients undergoing treatment.

Some improvements were noted in children and young people's services, however, with staff better at identifying sepsis.

Examples of positive and regular communication with child and adolescent mental health services were also noted.

Chief executive of at Kettering General Hospital Deborah Needham vowed to work hard to address the issues raises while noting the ratings reflected ‘immense operational pressures' on hospitals up and down the country.