A second surprise inspection has been carried out at the Basildon hospital maternity department - just three months after it was rated as inadequate.
Inspectors found a number of serious safety concerns, including not enough staff to look after women and provide the right care and poor leadership. A further inspection will take place to ensure improvements have been made.
The Chief Executive of the hospital's Trust apologised following the inspection in June and said improvements have been made.
The Care Quality Commission (CQC) inspected maternity services at Basildon University Hospital, run by Mid and South Essex NHS Foundation Trust, on 18 September 2020.
CQC's Chief Inspector of Hospitals, Professor Ted Baker, said: "On our return to Basildon University Hospital's maternity service, we were disappointed to see some longstanding concerns around staff culture and poor behaviours were still impacting on women's care.
"Doctors, midwives and other healthcare professionals did not always work well together, and the absence of an open culture meant that staff did not always feel able to raise issues or report incidents so that learning could be effectively shared to help embed improvements."
Examples of the serious concerns identified by the CQC:
The service did not always have enough staff to keep women safe
Staff did not identify and escalate safety concerns appropriately.
Multidisciplinary team-working continued to be dysfunctional, which impacted on further safety incidents.
Poor structure to the safety handover on the delivery suite and confusion to what constituted a safety huddle.
A longstanding poor staff culture had created an ineffective team where doctors, midwives and other healthcare professionals did not support each other to provide good care.
Leaders did not have the skills and abilities to effectively lead the service.
Some staff did not feel able to approach colleagues which did not benefit the care of women and babies.
During the latest inspection, CQC found several concerns which led to inspectors issuing an urgent notice of decision, under Section 31 of the Health and Social Care Act 2008.
This notice placed conditions on the trust's registration to enable the improvement of safety within the maternity service.
Following this inspection, maternity services at Basildon University Hospital remain Inadequate overall. The service is rated Inadequate for being safe, effective and well-led.
Professor Baker continued: "All staff we met during our inspection were welcoming, friendly and helpful. However, it was evident that many were concerned about the safety issues within their department.
"Inspectors received an action plan on steps to improve staff culture from the trust's leadership after the June inspection. These improvements were still in their infancy, however, and had not yet been embedded on our latest visit.
Professor Baker added that the inspection team escalated their ongoing concerns to NHS England and NHS Improvement. He said a risk summit has been held to discuss how to ensure sustained improvements are made.
"The leadership team is clear about the steps they need to take, and we will continue to monitor progress closely and will inspect again to check the necessary improvements have been made," he said.