The warning notice on the under-fire James Paget University Hospital (JPH) has been lifted, but new concerns over the management of medicines have been raised.

Hospital watchdog the Care Quality Commission (CQC) carried out an unannounced fourth inspection of the JPH - after three previous failed inspections - on December 7, 2011.

In light of a report from this inspection the CQC has lifted its warning notice on monitoring arrangements for quality of services and found the Trust to be compliant.

A warning notice regarding nutrition was also lifted last November which means there are no CQC warning notices in force for the Trust.

But the report highlights a specific concern about management of medicines.

Bernard Brett, medical director at the Trust, said: 'The focus has been on keeping paperwork on medications up-to-date and the development of a quick reference guide for prescribers.

'We have introduced a completely new drug chart to improve our process.

'Regular audits are taking place using CQC tools for medicines management. These check drug trolleys and storage of medicines. In addition, an enhanced training and awareness programme is being given to all staff that prescribe and administer medicines.'

He added governors specifically ask patients and relatives whether they have received appropriate information regarding their medicines during their ward visits.

Their feedback is then shared with divisional managers at the CQC monitoring group meetings.

Interim Chairman Peter Franzen said: 'We are determined to meet the high standards that our patients expect us to deliver and we're pleased the CQC inspectors are satisfied that we meet the standards on monitoring quality.

'The priority now is to make sure we continue to improve medicines management and maintain the progress we are making.'

Former chairman John Hemming stepped down from his role in November and chief executive Wendy Slaney announced her retirement from the NHS in December, as the hospital continues to make changes.

Hugh Sturzaker, lead governor, representing the Trust's public and staff members, said: 'I am pleased to see that the CQC has found improvements in the service we give to patients and would like to congratulate all the staff who have worked so hard to bring this about.

'Along with a number of governors I have been doing audits on the wards and have seen at first-hand the dedication, compassion and hard work of the majority of staff.'

Patrick Thompson, chairman of patients' group the Norfolk Local Involvement Network, said: ''We are pleased to read that the Trust is now compliant with the assessing and monitoring of its service provision.

'After a traumatic period for the staff and management, we are very hopeful that the measures taken so far will enable the Trust to continue along a positive pathway forward and will not allow standards to slip back.'

'However Norfolk LINk is still concerned that the CQC found a major concern over the management of medicines. We urge for action to be taken to address this issue with immediate effect.'

'Since December we have been carrying out unannounced visits to the hospital to ensure patient safety, dignity and their nutritional needs are being met to the highest level and we hope to continue with these and build on our partnership with the Trust.'

Maureen Carson, executive director of nursing, quality and patient safety for NHS Norfolk and Waveney, said: 'We're pleased the CQC has recognised improvements have been made. The CQC still has outstanding concerns in relation to a number of issues which the JPH is working to address. It is important for patients that these further improvements are made as speedily as possible and we will continue to monitor the JPH's action plan and support them closely over the coming weeks and months, liaising with the CQC and Monitor.'

Brandon Lewis, MP for Great Yarmouth, said: 'I am pleased to see that the JPH is making progress and that the CQC now feels that only one outcome is still a concern. It is now essential that the management up their game and sort this problem out as well. I am confident that they will soon resolve this issue and we can then focus on working to further improve our hospital'.