A hospital failed to carry out tests for malnutrition on a number of elderly patients within the necessary time, inspectors have found.
The checks – known as the Malnutrition Universal Screening Tool (MUST) – should be carried out within 24 hours of a patient being admitted.
But inspectors found that 18 out of 33 patients whose records they reviewed were not tested in the target time at the Victoria Hospital in Kirkcaldy, Fife.
In the case of one patient the test was not carried out until two weeks after they were admitted, while another had to wait nine days.
Healthcare Improvement Scotland (HIS) identified 10 areas for improvement in the report, which NHS Fife must address “as a matter of priority”.
These include ensuring nutritional screening is carried out for all patients within 24 hours of admission.
However inspectors also noted nine areas of good practice.
The unannounced inspection was carried out from Tuesday February 17 to Thursday February 19 as part of the HIS programme of inspections on the standard of care for older people in acute care in Scotland.
During their visit inspectors also noted that completion of fluid balance charts showing how much a patient had drunk was “generally poor” and the completion of food record charts “variable”.
The health board has been asked to ensure food and fluid balance charts are started and accurately completed for patients who require them and appropriate action is taken in relation to intake or output.
Jacqui Macrae, HIS head of quality of care, said: “This inspection found evidence that NHS Fife have made significant improvements following our previous inspections in May and December 2013.
“In particular, we found the completion of adults with incapacity documentation and the completion of assessments for patients on admission to hospital had improved.
“Staff told us they felt supported and we saw evidence that the majority of wards had made changes to improve the environment for patients with dementia.
“However, we did identify areas where NHS Fife must improve the care provided to older people. For instance, the completion of fluid balance and food record charts was poor, and medical and nursing documentation was not always dated and timed.
“This inspection resulted in 10 areas for improvement and nine areas of good practice. NHS Fife must address the areas for improvement we have identified as a matter of priority.”
NHS Fife said it is working to address the issues raised in the report.
Professor Scott McLean, director of acute services at NHS Fife, said: “NHS Fife welcomes today’s report which highlights that significant improvements have been made in a number of areas and that patients felt positive about their care and treatment.
“The report notes new initiatives aimed at improving patient outcomes, good use of frailty assessments, well managed mealtimes, good teamwork and strong leadership within wards, alongside ongoing work to support patient flow.
“Whilst these improvements are encouraging, we would reassure patients and their families that action is being taken to address the areas highlighted by the inspectors which require further work.
“A comprehensive plan has been drawn up to address the issues raised, with many actions already under way.”