Records show a hospital trust is “among the worst in England” for people spending more than 12 hours in the emergency department.
More than 900 people faced stays of such length in the month prior to a damning inspection.
The Care Quality Commission (CQC) has downgraded urgent and emergency care at Royal Albert Edward Infirmary in Wigan, Greater Manchester, after several concerns were raised over patient care.
A warning notice has been issued over the triage system, the identification of sepsis and how those with mental health needs are cared for after the unannounced inspection in May, with “rapid improvements” called for.
The trust said it was “working hard” to make improvements.
The NHS watchdog previously rated the urgent and emergency care and the medical care at the hospital – which was also inspected – as “good” but has downgraded them both to “requires improvement”.
Inspectors said the service was not meeting any of its sepsis targets citing two cases where staff had identified potential sepsis and follow up actions had not been completed more than 18 hours later. National guidelines state they should be done within an hour.
Inspectors found leaders had not ensured there were dedicated spaces to safely accommodate high-risk young people with mental health needs, with some staff saying they had experienced physical and psychological harm as a result.
Inspectors said the physical limitations of the department meant staff could not always respect people’s dignity and privacy. Some people raised concerns about being cared for in shared cubicles.
However, the report said staff were passionate about providing good care and people said staff treated them with kindness and understanding.
It said leaders had introduced transformation plans and “there were early signs of improvement in some areas, including the time taken to initially triage people and better ambulance handovers times”.