Dirty equipment and dusty floors found in a hospital raised "significant concerns" over cleanliness following an unannounced visit by inspectors.
The Healthcare Environment Inspectorate (HEI) reported finding dirty toilet seats and commodes, blood spots on blood monitoring machines and a dirty defibrillator during a visit to the Southern General hospital in Glasgow in August.
Inspectors also found "large amounts" of dust in several departments and wards, and noted that cleaning was "poor".
In ward 10, there was thick dust under beds and floors were dusty throughout while there was also a puddle of fluid on the floor beside one of the toilets.
A follow-up visit shortly afterwards revealed "significant improvements" in the cleanliness of patient equipment but found little improvement in environmental cleaning.
Commenting on the report on the two visits, Susan Brimelow, HEI chief inspector, said: "We carried out an unannounced inspection to Southern General hospital on August 22. A further unannounced inspection was made on September 2 because of significant concerns we had about cleanliness in some wards.
"This follow-up inspection found that there was still improvement required, although patient equipment cleaning was better. Our inspection team noted good compliance with NHS Greater Glasgow and Clyde's uniform policy.
"However, further improvement is required in relation to cleaning of the hospital environment and patient equipment, and staff need to have a better understanding of their roles and responsibilities in relation to maintaining a clean environment."
Rory Farrelly, the health board's acute director of nursing, said: "Clearly there are areas with our cleaning routines and estates management which need to be addressed.
"Immediate remedial actions have been taken to address the issues in the report which will ensure greater consistency in service delivery. These actions will ensure the four requirements made in the report are implemented rapidly."