An NHS hit squad will be sent into a home for the mentally ill in the Lake District tomorrow to overhaul the management after a scandal over abuse.

For the first time, the Secretary of State for Health, Alan Milburn, is using emergency powers to order the new Commission for Health Improvement (CHI) into North Lakeland Healthcare in Carlisle to investigate shocking revelations about the treatment of patients.

An external review found patients had been forcibly restrained and tied to a commode, sworn at by staff and fed liquidised food.

Others were denied adequate clothing or blankets.

"Clearly there is a serious problem as far as current senior management is concerned," Mr Milburn said. "A lot of these people are suspended or on sick leave. We have had to put in a temporary director of mental health. That is a temporary situation which is clearly not sustainable."

Peter Homa, the director of CHI, will arrive at the home today to lay the ground for his team's investigation, which could lead to a new management team being brought in.

The speed of the investigation, using powers that come into effect tomorrow, is intended to act as a warning to other health trusts that the Government is determined to stamp out bad performance by NHS management.

Mr Milburn's use of CHI as an "Ofsted" for the health service marks a shift from his predecessor, Frank Dobson, who wanted it to co-operate with managements.

The health secretary was shocked by the evidence of patient abuse and the failure to act on earlier investigations leading to allegations of an internal cover-up. He said the investigation would be "challenging and fair" but promised it would "root out poor practice".

The chief executive of the trust has been suspended with full pay, pending disciplinary action, for over a year since early 1999 when an inquiry uncovered the existence of an inquiry in 1996 that found evidence of abuse, but had been ignored.

Allegations included incontinent patients being forced to wash in soiled water, medication being hidden in sweets, and a patient was tied to a commode and fed at the same time. An external inquiry was ordered after the alarm was raised by the chairman of the trust into the abuse at ward 21, which was later renamed Kielder House.

The report by Dianne Jeffrey, who chairs a similar trust outside the area, was handed to Mr Milburn earlier this month with 24 recommendations including the destruction of physical restraint devices and a shake-up of management.