A care home has been ordered to make urgent improvements after inspectors found "widespread weaknesses".
The Care Inspectorate uncovered various issues at Tranent Care Home in East Lothian during an unannounced three-day visit in May.
While carers at the 60-bed home "wished to deliver good care" and were "pleasant and caring", inspectors noted they struggled to give residents the attention they require due to staffing problems.
They called on managers to improve training for staff and said the different needs of each resident need to be assessed in more detail.
Care Inspectorate officials noted treatment plans and power of attorney documentation were not always filed correctly, while they also found discrepancies in drugs records.
They also reported a "lack of interaction and stimulation" for residents.
Relatives raised several concerns about care in questionnaires issued by inspectors.
One family member wrote: "Residents shouting for help in their rooms and no urgency for assistance given.
"No buzzer near to them and some staff have been heard to say, 'oh they're always shouting', however I have seen residents who have fallen out of bed, been uncomfortable, unable to reach a drink or food (food and hot drinks left whilst residents sleeps at bedside for more than an hour) and in pain or needing the toilet and being told they were there an hour ago."
During the three-day inspection, there were several cases when "personal care was lacking", according to the report, published this week.
It said: "We met with some residents and found that they smelled less than fresh and clean. Some residents looked unkempt and had clothing that was past its best.
"There were people with unbrushed hair, unshaven men, people who were wet and not changed and some with food-stained and dirty clothing."
Inspectors also found discoloured bed linen in the home, which they said detracted from residents' dignity.
Other concerns included poor levels of staff during meal times, stains on floors and the need for a more regimented cleaning system.
"The culture in the home has led us to assess that the quality of life for many residents is poor," the report said.
"We have concluded that there are widespread weaknesses in the home and these must be addressed to enhance the quality of life for many residents.
"We were concerned about the experiences for people in the home."
Three of the four inspection categories - quality of care and support, quality of environment and quality of staffing - were described as unsatisfactory, while the quality of management and leadership was rated as weak.
A spokesman for HC-One Care, which operates Tranent Care Home, said: "We are very sorry that standards of care at the home fell below what we pride ourselves on and what our residents and their loved ones deserve.
"Immediately following the inspection we put in place a detailed and robust action plan to improve standards and make sure we provide kind and quality care.
"Our senior management team are working closely with staff at the home, as well as the Care Inspectorate and local authority."
He added: "We are grateful for everyone's support over the last three months since the inspection, which has helped to bring about improvements at the home.
"We are continuing to work very hard to make sure we keep building on the progress across all areas of care and we will do everything we can to ensure that we deliver kind and quality care now and in the future.
"The health, safety, and well-being of the people we support is at the heart of everything that we do."