Hospital patients were left "sobbing and humiliated" by uncaring staff, an investigation into one of the worst NHS scandals in history has found.
The independent inquiry claimed the Mid Staffordshire NHS Trust had become driven by targets and cost-cutting.
The report - the latest in a long line of critical reviews - said the distress and suffering had been "unimaginable".
Last year it was reported there were at least 400 more deaths than expected at the trust from 2005 to 2008.
But the relatives of patients treated there said many questions still remained unanswered.
In particular, they want a public inquiry into how the scandal could have happened, including the role of the wider NHS in the case.
The trust had been climbing the NHS ratings ladder during the period in question and was even given elite foundation trust status.
The Tories have said they would back a public inquiry, but ministers have so far resisted.
Instead, they set up this inquiry, led by Robert Francis QC, which has been held in private and mainly focused on what happened inside the trust and in particular Stafford Hospital, one of two run by the organisation.
Following publication of the inquiry report, the government said Mr Francis would now be allowed to look into the regulation and monitoring issues.
Stafford Hospital hit the headlines last year when a report was published by the Healthcare Commission claiming patients had been "dying needlessly" and put the number of excess deaths at more than 400.
It reported a catalogue of shocking examples, including cases where unqualified receptionists assessed people as they arrived at A&E.
The findings were then followed by two government reviews.
This latest report also outlines instances where patients were "routinely neglected".
It documents cases where patients were left in soiled sheets which relatives were forced to wash.
And it highlights examples where patients were left alone, leading to falls - some fatal, which were not reported.
And one woman, who gave evidence, told the inquiry: "My Mum was in absolute agony, I can hear her screams now, as I walked into the ward."
Half of the patients and relatives who gave evidence also cited problems getting enough food and drink.
The report criticised the "ineffective" management which was too often concerned with hitting targets, particularly in A&E, as well as the "lack of compassion" and "uncaring attitude" of staff.
But staffing levels were also said to be too low because the trust was trying to slash costs by £10m.
Julie Bailey, whose mother died at the hospital and the founder of the victims' campaign group Cure the NHS, said the handling of the scandal had been "disgraceful and unacceptable" - and reiterated her call for a public inquiry.
"It is time that the public were told the truth about the very large number of excess deaths of patients in NHS care and the very large number of avoidable but deadly errors that occur in NHS hospitals every day."
Since the original Healthcare Commission report, inspectors have been carrying out regular checks and have said care is now safe, although some problems persist over staffing and equipment.
The chief executive and chairman in charge during the period in question have been replaced and the General Medical Council and Nursing and Midwifery Council are investigating some of the staff involved.
Sir Stephen Moss, the new chairman of the trust, said: "I would like to apologise unreservedly for the harm and distress that people suffered during that time and thank those who spoke to the Inquiry.
"Their courage in coming forward has helped us learn from the errors of the past and to make changes that have already improved our services".
Health Secretary Andy Burnham said there could be "no excuses" for the failings.
But he added: "This was ultimately a local failure, but it is vital that we learn the lessons nationally to ensure that it won't happen again - we expect everyone in the NHS to read the report and act on it."
But Patients Association president Claire Rayner said: "The scale of problems at Stafford might have been unique but failures in essential nursing care are not."