Seven out of its 18 service areas are rated as requires improvement, including five mental health services. Ten services were rated good and one outstanding.
The review found issues with leadership, accountability and culture at the trust, including low morale, with surveys finding less than half of staff would recommend the trust as a place to work.
The watchdog said Freedom to Speak Up cases – a service which encourages staff to anonymously voice concerns – were up to 567 in 2024-25 from the previous year, with themes of staffing problems, patient safety, bullying, attitudes and behaviour.
Inspectors also found a “challenged” financial picture at the trust, with a forecast deficit of £46.8m at the end of the 2025-26 financial year.
The trust’s plan to break even was now expected to end £7.5m short due to “slippage” caused by higher than expected numbers of temporary staff and the use of beds out of its area.
Ceri Morris-Williams, CQC deputy director of mental health in the Midlands, said: “In 2022, we told the trust to make significant improvements and remove shared living, dormitory-style accommodation. We’ve told them to take immediate action to remove this accommodation and prioritise improving the estate and environments across its services.
“Due to the level of concern, around this breach and others breaches we identified, we asked the trust to submit an action plan that addresses how they will embed and make progress.
“We have told the trust where they need to make immediate and widespread improvements, and we will continue to monitor services to make sure people are safe while this happens.”