A used incontinence pad, a 40-minute wait for a toilet trip and an infection outbreak were among problems uncovered at care homes in southern England.
More than half of the 65 adult social care services inspected by the Care Quality Commission (CQC) were rated as inadequate or requiring improvement.
Inspectors at one care home in Devon said safeguarding concerns there "amounted to institutional neglect".
Twenty-seven out of the 65 services were rated "good" by CQC
Strong urine odour
Inspectors made unannounced visits to care homes and agencies that deal with patients ranging from young adults with Asperger's Syndrome to elderly people with dementia.