Bosses at a struggling mental health trust have vowed to take action after a damning review into its leadership revealed a “tolerance of poor standards”.

NHS Improvement, the national body which oversees health trusts, ordered the report into Norfolk and Suffolk Foundation Trust (NSFT) to fix issues raised when the service was put into special measures last year.

Inspectors from the Care Quality Commission (CQC) branded NSFT as inadequate in October for the second time in three years.

The watchdog laid much of the blame at the feet of the board of directors and said they had “failed to address all the serious concerns that had been reported to them since 2014”.

A new report by consultancy firm PricewaterhouseCoopers (PwC) will again make difficult reading for those at the top, who were accused of being too positive and quick to absolve themselves of responsibility.

Gary Page, the trust’s chair, pledged to “not shy away from these difficult issues” and said the team was “wholeheartedly committed to improving quality and safety”.

But the PwC report said the board needed to recognise its “collective and ultimate responsibility for ensuring that standards are being met” and that there was “a tendency to externalise things away from the board, rather than decide on clear specific action or intervention to be taken”.

It added “there was a tendency to be too positive about action being taken to address patient safety risks.”

Not enough attention had been paid to making cultural changes, it was found. Instead, the report said: “This trust has become accustomed to operating in a reactive manner”.

It added: “The board’s focus has been dominated by the quality, reputational and operational challenges the trust has faced.”

And there was a concern staff “do not identify with a vision or a strategy for the trust and have become passive to affecting change or improvement”.

But the report also said non-executive directors provided “strong challenge”. And the trust had developed an action plan, which will be presented today, to address the problems.

Mr Page said the board welcomed the report and said: “We recognise many of the issues which have been raised [...] and have already started to address a number of these, setting them as priorities within our annual plan.

“As a dedicated team which is wholeheartedly committed to improving quality and services, and to doing what is right for our patients and carers, our board will use this report as another tool in helping us make the changes we need to make.”