A Fife dementia ward condemned by inspectors as unfit for purpose in 2016 was still in need of an upgrade six years later.
The Mental Welfare Commission said patients at Queen Margaret Hospital in Dunfermline would find it difficult to find their own bedrooms due to a lack of signage on the walls.
And they found mouldy showers and stark, bleak corridors during a visit to ward one in October.
Fife health chiefs say some of the issues have now been dealt with under an action plan drawn up in the wake of the findings.
Concerns included maintenance issues which compromised patient safety and privacy.
And the garden was not dementia-friendly as it had many trip and fall hazards, a lack of comfortable seating and no shelter.
On the day of the inspection, the ground was littered with cigarette ends.
Meanwhile, shower facilities were described as “uninviting, dated and mouldy” and patients were unable to access two of the bathrooms.
Heavily stained flooring
Following the 2016 visit, the commission said: “We were concerned the ward environment was not fit for purpose and required a full refurbishment.”
They said NHS Fife had, at that point, given assurances about its plans for mental health wards.
However, during last year’s follow-up, the watchdog pointed to limited communal areas with worn and heavily stained flooring.
Inspectors also said they would have liked patients to have had more of their own possessions in their bedrooms.
Meanwhile, ward staff said they felt hampered and frustrated by the environment.
And inspectors noted the recruitment and retention of staff was a problem as it meant the ward had to rely on agency and bank workers.
Unpleasant experience for patients
Labour MSP Claire Baker this week wrote to NHS Fife to request an update on the findings.
She said: “Being stuck in hospital can be an unpleasant experience for most, but even more so for people with dementia.
“To not have access to some basic amenities will make the experience even more difficult, despite the best efforts of staff.”
Mrs Baker said the absence of dementia-friendly wards in hospitals across Scotland had been raised as an issue by inspectors for many years.
This is despite a national commitment in 2007 to make dementia a priority.
Improvements at Fife dementia ward began immediately
Rona Laskowski, head of complex and critical care services with Fife Health and Social Care Partnership, said a detailed action plan had been drawn up after the MWC visit.
And the service began implementing it immediately.
It includes a “significant programme of works” to refurbish the ward.
She said: “Specifically, investment has been made to ensure dementia-friendly improvements to the physical and therapeutic environment.
“This has included decoration and new flooring in the main corridor and purchase of dementia-friendly activities.
“We are also in the process of developing a new dementia-friendly garden area, specifically for this patient group.
“There has also been a review and refresh of the induction process to ensure that all staff feel confident and familiar with their work environment as part of the action plan.”