The chief executive of an ambulance trust has pledged there will be no bonuses for its top team after it was given just two weeks to make substantial improvements to cleanliness and infection control by the Care Quality Commission.

East Midlands Ambulance Service Trust could be fined up to £50,000 or have conditions put on its registration after inspectors found it had failed to carry out many of the actions the CQC had called for after an inspection in August.

It would be inconceivable to receive a bonus having failed an important inspection

During the follow-up visit in November inspectors found some ambulances were visibly dirty, as were suction units, defibrillators and forceps tips; some disposable equipment was being cleaned and reused; and only a small proportion of staff had received training in infection control matters in the past three months, although this was called for in the August report. Staff at one site said they had not seen a cleaning checklist until the morning of the inspection.

The trust was in breach of regulations about protecting staff and patients from healthcare-associated infections, and will now be required to improve by 14 December.

Ambulance trust chief executive Paul Phillips apologised to patients and said the service was disappointed with the outcome of the latest inspections but was responding.

“Since early November we have put in an awful lot more time and effort to make the service compliant. We have redoubled our efforts,” he said.

But he added he would not resign saying the service needed leadership at this time. But he said top managers in the service would not receive a bonus based on this year’s performance.

“It would be inconceivable to receive a bonus having failed an important inspection,” he said.

CQC infection control inspection programme manager Debbie Mead said: “We found insufficient improvement in basic matters such as ambulance cleanliness and the extent of training. This is the reason for issuing a statutory warning notice.

“Although there is no direct evidence that the shortfalls in infection prevention and control have caused harm to patients, the risk is not being reduced as much as it could be.”