INSPECTORS found Victoria Hospital is safe and clean – but said at risk patients weren't told about the possibility of infection.

NHS Fife chiefs were given a month to address the issue following the unannounced visit on November 30 and December 1.

The Healthcare Environment Inspectorate (HEI) met patients and staff and inspected wards and departments to assess cleanliness and to check that national standards were adhered to.

The hospital was also picked up for not filling out forms explaining the severity of patients' clostridium difficile (C.diff) infections, and not getting rid of single use patient toiletries once they'd been used.

But it was largely a positive report and a huge improvement from previous years, when a worrying drop in standards identified "significant risk" to patient safety and saw it reported to the Scottish Government.

Claire Sweeney, from Healthcare Improvement Scotland, said: “During our inspection of Victoria Hospital we noted the standard of cleanliness of the environment and patient equipment was good.

"We also saw staff adhering to standard infection control precautions while carrying out their duties.

"However, we identified issues for improvement. NHS Fife must ensure that, when infection risks to or from the patient are identified, all communication with the patients or their representatives is recorded in the patient record."

This requirement, which must be addressed within a month, arose after a check on the records of seven people in isolation for infection control reasons showed that advice and information was not being passed onto the patients.

The report said: "We were told that infection status, risks, advice and actions should be communicated to patients and their representatives by the clinical staff responsible for their care.

"We did not see any documented evidence of this in any of the seven patient records looked at.

"Nursing staff confirmed that this information was not recorded in the patients’ notes.

"However of those patients cared for in isolation, the majority told us that they were aware of why they were in isolation rooms and the precautions they should take."

The Kirkcaldy facility is Fife's only acute hospital with a range of services including accident and emergency and minor injuries services.

It has around 640 staffed beds.

Before visiting, HEI examined previous inspection reports at the Vic which "informed our decision on which standards to focus on".

A previous unannounced inspection, in December 2014, left inspectors “extremely disappointed” after finding staff not washing their hands and patient trolley frames contaminated by blood and bodily fluids.

This time they concentrated on prevention and control of infection, communication between staff and patients, and decontamination.

Inspectors went to the maternity unit, medical high dependency unit and wards 22 (renal), 23 (cardiology), 42 (stroke), 43 (respiratory) and 53 (surgical).

There was praise for staff compliance with standard infection control precautions, standards of cleanliness were good and nursing staff's documentation for patients with C.diff was also good.

But inspectors found that four out of 15 C.diff cases they reviewed either did not have a completed medical management form.

It provides staff with an at a glance day-to-day overview of the severity of the patient's infection and the inspectors recommended it should always be completed.

There are 10 key precautions staff should take to minimise the spread of infection, including hand hygiene, the use of personal protective equipment, such as aprons and gloves, and the management of linen, waste and sharps.

Of the 16 patients, relatives and carers who completed a questionnaire and nine patients interviewed, all but two said staff "always wash their hands".

They were also happy with the cleanliness of wards and patient equipment.

The report said: "If staff need to wear personal protective equipment, it should be put on immediately before providing patient care and removed immediately after.

"However, we saw some staff walking around the ward areas wearing aprons and gloves."

It added: "On the medical high dependency unit and ward 23, we found partially-used bottles of skin cleansing foam available for other patients to reuse.

"This product is for single patient use only. We discussed this with senior staff and it was removed from use.

"Similar issues were identified during the inspection to Victoria Hospital in December 2014 and August 2015."

The second recommendation, to be implemented immediately, said NHS Fife must ensure single use patient toiletries are discarded when no longer required by the patient.

Ms Sweeney said: “The NHS board has drawn up an action plan to address these issues.

"We will continue to monitor the cleanliness of Victoria Hospital at future inspections.”

NHS Fife chief executive, Paul Hawkins, said: “We are pleased that the report by HEI commends the cleanliness of the hospital and recognises the diligence of staff who work tirelessly to ensure our patients are cared for in a clean, high quality and safe environment.

"We note also that there is scope to improve written documentation of conversations with patients about infection prevention and control. "NHS Fife is committed to continually improving the standards of care we provide and measures are currently being put in place imminently to address this.”