Staff at troubled Mid Staffordshire Foundation Trust are “fatigued” according to the latest Care Quality Commission inspection, which also highlights concerns over staffing levels.

The CQC said the the trust’s clinical services at both Stafford and Cannock Chase hospitals were “only just adequate” and changes in just one or even two staff in key posts would make services unsafe.

During the inspection, some examples of high-quality care were found but staff, who were seen to be caring and committed to their roles, were described as “fatigued” due to “relentless” external scrutiny and uncertainty about the trust’s future.

Inspectors found the trust had a significant reliance on the use of temporary nursing and medical staff, which was seen to have a destabilising influence across the organisation.

In particular, the trust was “extremely challenged” when it came to nursing staff levels, with just three quarters of its substantive registered nurses available to work, said the report.

The remaining 25 per cent of nursing posts were not available due to vacancies, long-term sickness, maternity leave or suspension.

Senior managers were battling to fill nursing shifts and, Chief Inspector Sir Mike Richards, said: “Inspection teams were unanimous in their view that services would be unsustainable should any degree of winter pressures arise.”

He warned: “If recruitment or retention fell by even one or two people in some key posts, services would become unsafe.”

Inspectors found “the commitment of all the staff we met was evident”, and observed care delivered in a “compassionate, respectful and kind manner”.

Services at the trust are due to transfer from November when Cannock Chase will be taken over by the Royal Wolverhampton Hospital Trust and Stafford Hospital will go to University Hospital of North Staffordshire.

“The current uncertainty is contributing to the fatigue and fragility amongst staff,” the report said.