Isle of Wight NHS Trust set to enter special measures
Health services on the Isle of Wight are set to be put into special measures after the NHS watchdog found a "deterioration in safety and quality".
The Care Quality Commission (CQC) highlighted low staff morale, unsafe mental health wards and "out of touch" management in a leaked document seen by the BBC.
The CQC has declined to comment until its report is officially published.
The chief executive of the Isle of Wight NHS Trust resigned on Friday.
A draft letter written by the chief inspector of hospitals, Prof Sir Mike Richards, outlining the findings of its forthcoming report, rated the trust as "inadequate" and said there had not been enough progress made since the last CQC inspection in 2014.
Among the key findings were mental health wards which it described as "unsafe", for example, it found regulations were breached by staff failing to report incidents.
Patients' dignity was not protected, with male and female patients having to share the same bathrooms, and it found staff had not sought patients' consent for treatment or examination, in some cases.
'Out of touch'
The report also raised staff shortages as an issue and noted that employees' morale was "low".
"Staff in many services were disillusioned and suffering work overload: some described bullying and harassment," it said.
The trust's "top-down" culture was criticised, with senior managers "failing to understand" what changes were needed and executives "out of touch" with what was happening on the front line.
It also found inadequate risk assessment of patients, an "insecure" ambulance station, delays in handovers from ambulances to emergency department, missed treatment targets and cancelled operations.
Analysis: David Fenton, BBC South health correspondent
Patients at risk, staff disillusioned, bosses inadequate - how much worse could it be?
One hundred and forty thousand people rely on the island's health service - it's hard not to think they've been let down.
This is a difficult time for the trust whose leadership has been slated from the board level down.
The acting chief executive has apologised and reassured the patients and public that issues are being taken very seriously.
Things need to change. How soon and in what way will become clear when the CQC report is published in full.
Karen Baker stood down as the trust's chief executive in March, ahead of the CQC's report, saying after five years in charge the trust needed a "fresh pair of eyes".
In her resignation statement, Ms Baker said: "It is true that the NHS on the Isle of Wight - like elsewhere - faces many big challenges and it is clear to me that we have not always provided the quality of care the public expects. I am very sorry about that."
Acting chief executive and medical director Dr Mark Pugh said the trust was taking issues "very seriously" and apologised for "where there have been failings".
"Staff have been working hard to address the issues raised by the CQC since they were brought to our attention.
"Our focus is on providing safe quality care for patients, preparing for publication of the finalised report - which we hope will be soon - and developing an improvement plan which we hope everyone on the island will support," he said.