The quality of care at a “gridlocked” ambulance service has declined, according to the health watchdog.

South East Coast Ambulance Service NHS Foundation Trust was rated requires improvement following an inspection by the Care Quality Commission (CQC) between July and August.

The categories of safe, effective and responsive were rated requires improvement while the well-led category saw the trust rated inadequate.

However, the care category saw the trust achieve a good rating.

Deanna Westwood, CQC’s network director, said the service’s staff were doing their “utmost” to provide safe and effective care, but that due to “additional pressures” on the service, which included an increase in staff sickness and increased delays in handovers from partner organisations, meant that the quality of care had “declined”.

She said morale within the trust was “low” and that staff did not feel appreciated by management.

“It was for this reason that we have changed their overall rating from good to requires improvement,” she said.

“Leaders were very aware of our concerns in relation to the trust's performance and have showed a real sense of urgency in prioritising the issues which had been identified, which is encouraging.

“As flagged in CQC’s report published last week, State of Care, the South East like many other areas, has a health and social care system that is gridlocked. The trust can’t solve all of their issues, such as handover delays alone, and I encourage the whole system to work together to find a resolution.

“We did have other more specific concerns that we have told leaders about. For example, they need to have better oversight on how often restraint was used and if it was done safely.

“Although staff knew what incidents to report and how to report them, they weren’t always reporting when somebody had been restrained.

“We also spoke with staff within the resilience team, who were frustrated and didn’t feel respected, valued or supported. There was low morale within the service and staff told us they didn’t feel appreciated by management at a senior level.

“We continue to monitor the service closely and will be returning to check on the progress of improvements that the trust has been told to make.”