The director of nursing at James Paget University Hospital has vowed to “drive improvements forward” after the hospital was handed a formal warning from the Care Quality Commission (CQC) when it failed its second inspection in six months.

A CQC report raised serious concerns with the hospital in Gorleston after it discovered some staff had ignored elderly dementia patients and left their food to go cold on bedside tables.

Meanwhile, inspectors also discovered lapses in hospital practice where staff had failed to record nutrition charts meaning some elderly patients who could not communicate their needs were not given food and drink they required.

The hospital is at risk of being prosecuted, having its services restricted or even shut down if standards cannot be met.

But director of nursing Carole Crocker believes progress is already being made to rectify the standard of care to ensure patients receive the best quality treatment in the future.

“Our priority remains with the patients and their experience at the hospital,” she said. “We have taken the concerns raised very seriously and have been working hard to ensure we provide the highest standards of care for our patients.

“Our staff have responded to the challenge and have adapted to the changes in practice. They have already noticed the positive impact this work is having on the patients’ experiences and we are grateful for their support in driving our improvements forward.”

Managers at the hospital say they have already addressed gaps in a system designed to protect elderly people.

Meanwhile, bosses are putting their faith in a new system for meal delivery, which relies on meal coordinators ensuring patients get the support they need.

Chief executive of James Paget University Hospital Wendy Slaney said: “The report shows that additional measures were required to ensure consistency in respect of nutrition.

“Building on the work already in place, there has been a major change implemented for mealtime organisation and delivery, with increased support and follow-up for all aspects of nutrition for patients. The CQC recognised progress and good practice across the range of other outcomes assessed at the visit.”

The hospital insists it will pass its next inspection, otherwise it will run the risk of health watchdogs intervening.

In response to the CQC inspection, the hospital added: “The patients interviewed by the review team spoke positively about their experiences at the hospital and felt they were well informed, involved in decision making and were complimentary of the care provided.

“The CQC reported a number of positive examples where staff were very supportive to patients and understood and responded to their specific needs.”

The James Paget University Hospital has 544 beds.