Inspectors say improvements must be made at a mental health hospital in Northampton.
The Care Quality Commission says St Andrew's Healthcare, which has almost 860 inpatient beds, is suffering from repeated and systematic failings.
The report says plans to improve were still in their infancy.
St Andrew's treats people with mental health issues, learning disabilities and autism in the Midlands and Essex.
The report highlighted that there was a two year backlog in addressing some issues and some of them weren't covered by routine reports so the board may not have been aware of all of the concerns.
CQC has told St Andrew's Healthcare it must make several improvements, including:
Ensuring effective governance systems and processes are embedded across all its services, supporting sustainable and high-quality care.
Reviewing arrangements for independent challenge of decisions made by its executive team.
Timely actioning and completion of all regulatory breaches and concerns identified by Mental Health Act reviews.
Affording all staff raising concerns protection in accordance with The Protected Disclosures Act 2014 and adhering to its own policies and procedures.
Embedding systems and processes for shared learning across all its locations. Ensuring restrictive practices - including physical restraint - continue to be reviewed across all its services, reducing these in line with guidance.