The NHS trust in charge of Watford General Hospital has been put into special measures after inspectors found serious failings in the safety and quality of its care for patients, including untrained receptionists assessing how unwell new arrivals at A&E were.

West Hertfordshire Hospitals NHS Trust has been ordered to make big improvements after watchdog the Care Quality Commission rated its services as “inadequate”.

In the report released today, inspectors said that Hemel Hempstead Hospital needed improvement overall, while Watford General and like St Albans City were judged to be inadequate.

CQC inspectors visited the trusts’ three hospitals in April and May and uncovered a series of problems, including A&E patients at Watford General facing long delays before they were examined by a doctor, untrained staff assessing and directing the care of A&E arrival, a lack of nurses so serious that it posed “a major risk” to patients, and major staff shortages in its maternity unit.

In addition, inspectors deemed patient safety “was not a sufficient priority”, there was a failure to act on the lessons of previous incidents, facilities were in such bad repair they “caused a potential risk to staff and visitors and vital equipment including resuscitation machines was not always checked to ensure it was working.

Sir Mike Richards, the CQC’s chief inspector of hospitals, said his team’s findings meant he had to recommend the trust, which provides care for around 500,000 people in Hertfordshire, was put into special measures.

CQC inspectors led by Tony Berendt, the medical director of Oxford University Hospitals NHS trust, said that although most staff were caring, compassionate and kind, quality of care was undermined by longstanding understaffing and overreliance on agency and locum staff.

The 300-page report praised children’s and young people’s services as outstanding, but found the approach of some staff within the maternity unit and outpatient department “required improvement”.

Additional areas for concern included the "lack of a safety culture” and the lack of a systematic approach to the reporting and analysis of incidents.

Mr Richards praised the trust’s interim chief executive, Jac Kelly, for understanding the problems there and taking decisive action to tackle them.

Mrs Kelly told the Observer: "We will work at pace to put right the shortcomings or risks that were identified.

"I want to emphasise that since that visit risks identified have either been put right or we are actively involved in making the necessary changes so that we can confidently say we are delivering a safe service."