A specialist brain injury hospital has been told it must improve following a health watch dog inspection.

An inspection by the Care Quality Commission at the Royal Hospital for Neuro-disability, based in West Hill, Putney found that patients' consent was not always sought before procedures were carried out and assumptions were made without supporting evidence.

Though all staff had basic in-house training in safeguarding, wider issues were not known and higher level training was not given.

The quality and variety of food was also criticised in the report.

An official rating was not given, as the hospital was part of a pilot scheme.

December 2014: Michael Ball visits Royal Hospital in Putney

The chief inspector of hospitals, Professor Sir Mike Richards, said: "Our recent inspection has found that the Royal Hospital for Neuro-disability has made significant changes in leadership, governance structure, senior staff and organisational culture within the last year. "It is clear that the new leadership team is still in the process of embedding changes to processes and procedures.

"Patients told us that the majority of staff treated them with dignity and respect, and that the hospital chaplain in particular provided excellent support to them and their families.

"However, we have concerns about the reliance upon agency nurses and healthcare assistants to maintain sufficient staff levels, and that staff members were not always trained to deliver the services required by patients."

During the inspection, the hospital's brain injury service, specialist services and specialist nursing home were assessed.

Chief executive Paul Allen said: "We are delighted the CQC recognised our use of technology and our exceptional chaplaincy service.

"The RHN is a unique environment.

"We have been providing rehabilitation and long-term care for people with profound disabilities for many years.

"We constantly strive to make sure the complex regulated environment within which we operate is adhered to in ways which are relevant and appropriate to the patient group we care for.

"The CQC recognise that we provide excellent support for patients and their families.

"Patients, their families and those who commission our services can be assured that the safety and wellbeing of all those entrusted to our care is our priority at all times.

"It is a privilege to care for those who use our services at the RHN and we will do all we can to ensure we continue to provide the very highest standards of care."