A warning notice has been issued to Sherwood Forest Hospitals Foundation Trust after a highly critical inspection report found “abysmal” staffing levels.

Care Quality Commission inspectors found there were insufficient nurses and doctors and described a string of failures at the trust which is already in significant breach of its licence with Monitor.

The trust is in ‘special measures’ and is one of 14 hospitals examined in a review by NHS England medical director Sir Bruce Keogh after concerns over high mortality rates.

During the inspection, in June and July, the CQC visited the trust’s accident and emergency department and 16 other wards. It spoke to 75 patients and 100 staff.

Inspectors were told by patients that staffing levels were “abysmal”. One relative said: “My wife rang me in tears because she could not get any one to help her, they are so busy.”

Nurses said staffing levels were “horrendous”, with one saying: “We cannot go on, it’s terrible, nurses are crying because it’s so bad in here.”

Another added: “It feels like we’re being told there’s ‘no agency, no bank [staff available] – get on with it’.”

The CQC found the trust had a 50:50 ratio of nurses to healthcare assistants on most wards. The older people’s wards had one nurse for eight patients during the day and one nurse for 12 patients at night – less than the one to five ratio suggested by the Royal College of Nursing.

Junior doctors told inspectors a lack of staff at weekends increased workloads, meaning mistakes had been made with prescriptions.

Trainee doctors said they did not always feel supported by senior staff and had been asked to make end of life decisions despite being uncomfortable to do so.

The CQC found problems with the way outlying patients on wards away from the specialty providing their care were reviewed with one nurse saying part of their role was being “a good detective” to identify responsible consultants.

Inspectors also found patients not being helped to eat or drink with poor charts and incorrect or absent risk assessments.

The trust also had a backlog of complaints, X-rays and scans.

Trust chief executive Paul O’Connor said: “We are confident that measures have been put in place to address all findings from these reports and recognise the need to give additional attention to bring further improvements for our patients.”