A friend and I spent two weeks in February at the Conch Shell and were perfectly comfortable.
This was our first trip to AC, so - not knowing what we'd find - we reserved two rooms for one night over the phone, figuring we could use our first day in town to prowl around and move to another hotel if we needed to. We chose to stay.
Some rooms have refrigerators, some don't. At least one has a kitchenette, I believe. None have a/c. The water pressure is low but sufficient; I never had hot water problems (and I take long showers) or plumbing problems.
I don't recommend sitting on the balcony rails. I do recommend making friends with the crew over at Cholo's, next door.
The place is simple and cheap, and we were well treated. NOT fancy. If I were trying to impress a lady, I wouldn't take her there. Of course, if I'd brought her to Ambergris Caye and she wasn't impressed yet, then the choice of hotel probably wouldn't help much, anyway...