Most hotels use comforters over duvets or quilts. However, it's not uncommon for hotels to provide an additional blanket for use with the comforter.
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Sheets are usually changed between guests, and sometimes state law requires it, but there's no guarantee that they will be. As for bedspreads, forget it. As countless hidden-camera investigative TV programs have confirmed, they aren't washed regularly.
Mid-range hotels tend to change sheets every 2-3 days on average. However, policies vary by hotel brand and individual property management. Budget hotels and motels may leave sheets unchanged for multiple nights or even an entire stay unless the guest requests fresh linens.
The frequency at which hotels clean their comforters can vary. Some hotels may wash them after every guest checks out, while others may not wash them as frequently. This variation is due to hotel policies, resources, and time constraints.