Inspectors have identified 10 areas in which Victoria Hospital must still improve, following an unannounced inspection in February.
In its report published this week, Healthcare Improvement Scotland- which focuses on compassionate care for the elderly - said NHS Fife had made “significant” progress since previous inspections in 2013.
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 dementiaJacqui Macrae
That year, inspectors found some elderly patients at Victoria Hospital in an alarming state of malnutrition and strongly criticised its care of patients with dementia.
An unannounced inspection in February - which covered seven wards as well as the admission unit - revealed NHS Fife had since achieved nine areas of good practice.
Jacqui Macrae, head of Quality of Care, said: “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.
She added: “NHS Fife must address the areas for improvement we have identified, as a matter of priority.”
Inspectors also noted NHS Fife still “boarded out” patients to alternative wards due to capacity problems, but the process was better coordinated and was no longer putting patient at significant risk.
It did, neverthless, impact on quality of care.
Commenting, Health Secretary Shona Robison said it was clear staff throughout the hospital had “worked hard to make positive changes to the quality of care and the hospital experience”.
She praised areas of good practice noted by inspectors and findings which showed “clear, strong leadership” from senior charge nurses and clinical nurse managers at the hospital.
Elderly patients deserved to have complete confidence in the quality of hospital care provided and these inspections - introduced by the government - helped improve services, she said.
She concluded: “However, delivering the highest quality of patient care is a key priority and that is why I expect NHS Fife to urgently address the identified areas for improvement, in particular the concerns raised regarding patient flow and capacity at the hospital and the effect it has on the quality of patient care.”