Failures in infection control, hygiene, staff levels and medical records have been uncovered at Watford General Hospital, following an unannounced inspection.
The hospital, in Vicarage Road, failed to meet NHS standards in five of six key areas when a health watchdog team visited in December.
A report by the Care Quality Commission (CQC) raised concerns after its team found dried blood in a corridor, medical records containing information about the wrong patients and treatment being delayed due to staffing pressures.
However the commission’s report also praised the way staff treated patients and highlighted areas where the hospital was improving under the new management team.
The CQC sent an inspection team to the hospital on December 17 and spoke to 29 patients and 40 staff members during the visit.
Responding to the report, Samantha Jones, the chief executive of the trust incharge of the hospital, said efforts were already being made to improve care at the hospital.
In its report the team found patients were largely positive about the way they were dealt with by staff.
"In most case people were complimentary about the attitude of the staff," the report said.
"Comments included, ‘the staff are wonderful’, ‘staff are brilliant, I couldn’t fault them’, ‘it’s constantly busy but nothing is too much trouble for them’."
However the team observed cases were treatment was being given without cubicle curtains being drawn and without staff explaining the treatment to the patients.
The inspectors also noted the list of confused patients, such as dementia sufferers, in the Acute Admissions unit (AAU) - a ward which most patients in the hospital pass through - was called "wander watch".
Looking at treatment patients received, the inspectors praised the trust for bringing down its mortality rate for people who have fractured a hip from 12 per cent to six per cent, which is below the national average.
Yet in the AAU ward, inspectors found that patient transfer time targets meant the treatment of patients was often interrupted or delayed as staff dealt with incoming patients.
The report said: "This meant that the pressure of bed management may place people at risk of unsafe care or treatment by delaying them in receiving the tests and treatment required."
The report also said poor hygiene and cleanliness at the hospital was leaving people at risk of infection.
Inspectors found cases of mattresses not being cleaned properly as they went around the wards.
In A&E they discovered a pillow on a bed "marked with large stains" and a dried blood on the floor between the department and the fracture clinic.
When inspecting a cubicle in Aldenham Ward, the CQC team discovered "high levels" of dust as well as a used plaster, a straw and orange fruit under the bed and a large dark stain on a chair cushion. In another ward they found a blood stain on the toilet wall.
Looking at staffing levels the, CQC concluded there was not enough experienced staff in AAU to meet patients’ needs. Inspectors were also not convinced that staff were being sufficiently monitored and found low numbers of doctors had been appraised.
The report criticised the trust for not having an effective system in place to regularly access and monitor the quality of service patients received. It said the governance department was significantly understaffed and found that serious incidents investigations were not always completed by trained investigators.
The CQC also discovered two patients’ medical records, which contained blood tests results and a request for a scan relating to someone else.
It also uncovered reports stating patients were not at risk of malnutrition that did not include vital information such as their weight or height.