Independent healthcare regulators have found "unacceptable levels of care for older patients" at a Cheshire hospital.
Investigators looked at standards of care at Leighton Hospital, Crewe
Their report was prompted by ward sister Barbara Salisbury's two attempted murder convictions in 2004.
Serious lapses in the care of older people at Crewe's Leighton Hospital were uncovered in a report by the Healthcare Commission.
Mid-Cheshire Hospitals NHS Trust accepted the findings, and said remedial work had already started.
The conviction followed overdoses of diamorphine, a powerful opiate analgesic, being given to patients at the hospital in 2002.
Recruit additional frontline nursing staff to provide an acceptable and safe standard of care
Improve governance and management of the medical directorate
Investigate and address the cause of poor clinical outcomes in the medical directorate, including apparently higher than average mortality rates in recent years
Review management and accountability arrangements in the trust
The investigation looked at the situation around the time of the deaths and to see if improvements had been made. It found the trust failed to meet adequate standards of care.
It also pointed towards poor leadership and management, staff shortages and a lack of learning from complaints, leading to the safety of patients being compromised.
Patients were often not helped to take medication, or with eating and drinking.
The commission found a general lack of attention by staff sometimes prevented patients from getting to the bathroom or using the bedpan in time. It said this affected their "dignity, morale and health".
Healthcare assistants reported having little time to shave patients or answer buzzers.
Investigators found "numerous examples" of drug rounds being late and tablets left on tables out of reach of patients.
Marcia Fry, head of operational development at the Healthcare Commission, said: "There is no excuse that allows for the care and dignity of patients to be compromised in this way.
"This report has highlighted serious problems, some of which go right up to the most senior level at the trust."
Barbara Salisbury was convicted of two counts of attempted murder
Mid Cheshire Hospitals NHS Trust has drawn up a plan to address the recommendations.
It has carried out a "high level review" of management arrangements, recruited 44 nursing staff, and introduced a new approach to handling and learning from complaints. An audit of the care of older people has been launched.
Alan White, trust chairman, said: "On behalf of the trust board I welcome the publication of this report and totally accept its findings and recommendations.
"The safety, care and dignity of our patients is paramount and I would like to reassure both them and the general public that we are absolutely committed to taking whatever action is necessary to implement the Healthcare Commission's recommendations in full.
Cheshire and Merseyside Strategic Health Authority and the Healthcare Commission regional team will closely monitor progress made against the action plan.
Salisbury, who moved to Mold, Flintshire, was jailed for five years in June 2004 for the attempted murder of May Taylor, 88, and Frank Owen, 92, at Leighton Hospital.
She lost a Court of Appeal bid to overturn the convictions in November 2005.