A hospital in Bath has been downgraded from "good" to "requires improvement" by the health watchdog.
The Care Quality Commission (CQC) carried out unannounced inspections of the Royal United Hospitals Bath NHS Foundation Trust's medical care service in July and August.
Inspectors say the visit came after "receiving information of concern regarding the safety and quality of care".
Medical care services at the wider local NHS trust, Royal United Hospitals Bath NHS Foundation Trust, were downgraded following the inspections.
This led to a subsequent downgrading of the hospital as a location, although the trust's overall rating as a provider of care remains "good".
The CQC report states that "the design, maintenance and use of facilities, premises and equipment were not adequate" and "patient fluid charts were inconsistently completed".
The report also notes that there was "a lack of healthcare assistants available", adding that "on some wards, staff did not record medicines in line with the trust’s policy".
A statement from the CQC reads: "The CQC has downgraded the ratings of medical care services at Royal United Hospitals Bath NHS Foundation Trust, from good to requires improvement.
"The amendment of this rating has also affected the overall rating of Royal United Hospital Bath at location level, which moves from good to requires improvement.
"CQC carried out an unannounced focused inspection of medical care (including older people’s care) at Royal United Hospital Bath, after receiving information of concern regarding the safety and quality of the care being provided.
"Effective, caring and responsive were not inspected at this visit. Responsive remains rated as requires improvement, effective remains good and caring remains outstanding.
"As a result of this inspection, the overall rating for Royal United Hospital Bath, as a location, has dropped from good to requires improvement.
"The overall rating for Royal United Hospital Bath NHS Foundation Trust as a provider overall, remains rated as good."
The Royal United Hospital says it has welcomed the report and has begun working on the required improvements.
A spokesperson said: “We were pleased that the report also identified many positives, inspectors praised the "outstanding programme" for international nurses, our ability to manage patient safety incidents well and the way managers and ward leaders were supported to make the wards a welcoming place to work.
“Inspectors noted that our medical care service had enough medical staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment.
“The CQC also acknowledged that we have a strong vision and strategy developed in partnership with the people we care for, the people we work with and the people in our community.
“The RUH is committed to being an organisation where everyone matters and we would like to reassure patients that our staff remain fully committed to providing the very best standards of care at all times", the spokesperson added.