A "toxic culture" at a troubled NHS trust is risking patients' lives, say several current and former staff.
Managers and medics have told BBC News that people are fearful of speaking up amid a bullying, blame culture at the East Kent Hospitals Trust.
The BBC has already revealed how a man with dementia was restrained by security on 19 separate occasions to allow treatment to be administered.
The trust says it takes all staff concerns and complaints seriously.
The East Kent Hospitals Trust is at the centre of an independent investigation into maternity failures and has been criticised by inspectors for failing to prevent patients catching coronavirus at one of its hospitals.
"It is so badly broken," said one manager, but the trust leadership is "so, so arrogant that it will not listen".
"If your face doesn't fit, they come after you," said another nurse. The trust has two main sites in east Kent; the William Harvey Hospital in Ashford and the Queen Elizabeth the Queen Mother Hospital in Margate.
"The bullying culture exists across the two sites but it's more overt at the William Harvey," said a manager.
Recent concerns about the actions of senior leadership have included the management of Covid-19 at the William Harvey and the treatment of some staff following the poor care of the patient with dementia.
The trust was the first in England to be criticised by the Care Quality Commission for the way it dealt with coronavirus, with high numbers of people contracting the virus in the Ashford hospital.
The trust did not have an infection control director until the CQC raised concerns, an example not just of poor management but also of its "arrogance", according to a former employee.
Some staff were astonished when nurses and managers who were not involved in the care of the man who was repeatedly restrained were suspended, yet those directly responsible were initially allowed to continue treating patients.
"I wouldn't necessarily ask to be taken there in an ambulance," said a close observer of the trust.
"It's geographically on the edge, so it doesn't attract the biggest and best talent.
"It struggles. It doesn't have the turnover of staff that bring in new ideas."
While the BBC has heard criticisms about several members of the executive team, the actions and management style of the trust's chief operating officer, Lee Martin, appear to have caused the most concerns.
While people recognise him as hard-working, and praise his efforts at improving A&E performance and preparing the trust for a possible no-deal Brexit last year, he has variously been described as "bullying", "vindictive" and "hysterical, prone to shouting and swearing" in meetings.
One female manager said he'd been known to message staff on their phones during meetings that he's attending, telling them to stop talking, while his temper outbursts have occasionally left some colleagues in tears.
"He's not a leader, he's a dictator," said a manager. "NHS England knows what he's like."
Mr Martin, who joined the trust in 2018, has previously worked in hospitals in both Australia and London.
In Canberra, a parliamentary inquiry into a scandal around the manipulation of waiting times, which Mr Martin was not involved in, nonetheless heard concerns about his leadership style.
Several staff said he had "demonstrated inappropriate managerial behaviours", while the head of Canberra Hospital told Australian politicians that "on a couple of occasions, issues [were] brought to my attention in relation to Mr Martin's management approach.
"I have spoken to Mr Martin and we are working with his executive coach in relation to matters that have been raised."
On returning to the UK in 2013, Lee Martin was appointed chief operating officer at the Whittington Hospital in north London.
Again, the BBC has been told, concerns were raised about his "very assertive managerial style", including some staff saying they felt bullied by him.
He left the Whittington to join the London Northwest Healthcare Trust in 2015 before moving to Kent.
All the allegations were put to Mr Martin.
He has chosen not to respond.
In a statement, the East Kent Hospitals Trust said: "We take all staff concerns and complaints extremely seriously and are committed to listening and acting on feedback.
"There are several ways that staff can raise concerns or make complaints about the behaviour of colleagues and we would encourage any member of staff with a complaint or a concern to contact the chief executive, their line manager or one of our Freedom to Speak Up Guardians so the matter can be properly investigated."