Dirty ambulances and equipment have put patients at risk of infections, according to a damning report.

Inspectors who carried out spot-checks at seven East Midlands ambulance stations – including Loughborough and Narborough Road in Leicester – discovered a catalogue of hygiene problems.

Among the most serious was medical equipment which should have been thrown away after one use being cleaned and used again. These included forceps used to remove foreign bodies from the mouth and throat.

Inspectors found that as well as being reused, "most" of the forceps they looked at were also "visibly dirty at the tips".

Other equipment had been removed from sterile packaging and put in "response" bags ready for use.

Not all of the ambulances inspected in Leicestershire had a supply of hand detergent wipes, which are key to helping stop the spread of superbugs such as MRSA and Clostridium difficile (C Diff), and four out of seven hygiene hand gel dispensers inspected at the ambulance stations were empty. The unannounced checks were carried out by officials from the Care Quality Commission, who also found 19 of the 30 staff they spoke to had not received formal training on prevention and control of infections for more than two years because they were too busy.

In their report, the officials said: "On inspection, we found evidence the trust has breached the regulation to protect patients, workers and others from the risks of acquiring healthcare-associated infection."

The commission has now given East Midlands Ambulance Service NHS Trust a month to clean up its act. The trust has said it has now put "an action plan" in place.

The inspectors, who carried out the checks in August, added in their report: "It was clear that some emergency ambulances had not been through a recent deep clean, nor had any recent general cleaning been performed."

They said staff had no guidelines or check lists regarding how to clean effectively, and were not aware of any day-to-day cleaning arrangements.

Some 18 emergency and patient transport vehicles inspected were visibly clean, said inspectors, with the exception of three in Nottingham where, in one instance, thick black dirt was evident.

A spokeswoman for the trust said: "Immediately following the inspection we reviewed our practices and put in place an action plan to address the points raised by the Commission."

She added: "Single use instruments should not be reused and we are making this clear to our staff.

"We are redoubling our efforts to ensure that our vehicles are clean and fully stocked with hand rub at all times and that staff are aware of cleaning schedules.

"We have also taken steps to ensure the full decontamination of all relevant equipment.

"We will observe practice and inspect equipment to ensure this is done."

Zuffar Haq, co-chairman of the Leicester City local involvement network, said: "It's not the staff at fault. The trust should provide adequate training, facilities and equipment.

"By trying to achieve response time targets the trust has been putting patients' safety at risk.

"Clostridium difficile and MRSA can be killer bugs."

David Gorrod, chairman of the Leicester Mercury patients' panel, added: "Action taken must be done in a way that the public can be convinced and assured this decontamination and cleaning is being carried out."