The hospital trust at the centre of the C-diff scandal has improved a year on - but could still do better when it comes to handling complaints.

In its latest report, the Healthcare Commission says the Maidstone and Tunbridge Wells NHS Trust must improve how it handles patient complaints and has warned: "Now is not the time to relax."

The commission, the healthcare watchdog for England and Wales, carried out inspections one year on from its damning report in October 2007. That report revealed an estimated 90 patients died from the C-diff superbug between 2004 and 2006, previous hospital managers failed to understand the seriousness of the outbreaks, and quoted incidents of nurses so rushed they told patients to go to the toilet in their beds.

The latest inspection, published on Friday, commends the trust for reporting low rates of C-diff infections, finding its current rates are among the lowest in the country.

It also notes improvements such as better cleaning, a dedicated action plan on how patients with the infection will be treated, new isolation wards, a larger infection control team, and management and board changes which made reporting of risks easier.

The commission’s head of investigations, Nigel Ellis, said: “This is a very different trust to the one we investigated in October 2007. Staff at every level have put in considerable effort to make these improvements and should be recognised for their hard work.”

But inspectors said the trust must improve how it learns from complaints and serious incidents within its hospitals.

Evidence analysed by the commission indicates the trust has consistently been in the top three in the South East Coast health authority area for the number of complaints it receives.

Inspectors said: “It was not clear how incidents or complaints generated action plans, or where they did if these were followed through. The system for responding to complaints needs to be reviewed.”

Mr Ellis added: “Now is not the time for the trust to relax. Its infection control systems need further improvement and more nurses are needed, and it must make sure it learns from complaints and serious incidents.”

Some relatives of those who died in the outbreaks have said previously that they felt previous management were not listening to their concerns.

A trust spokesman said a new head of quality of governance and a new patients’ complaints team had been appointed to tackle complaints and that it was continuing a drive to recruit more nurses.

In a separate unannounced Healthcare Commission visit in October, under the hygiene code, inspectors found some hand basins in one ward at the Kent and Sussex Hospital were inaccessible, raised concerns the way equipment was moved, and found an unsuitable hand wash basin in the hospital’s endoscopy suite.

The commission said on a later inspection these issues had now been dealt with, by installing improved hand-washing facilities.

Glenn Douglas, the trust’s chief executive, said: “This is a very positive report one year on from the original devastating one.”

The trust has successfully applied to the Health Protection Agency for a grant of £160,000 to fund studies into the superbug.

The trust will work with the Kent Health Protection Unit and the study will look at how different patients respond to having C-diff, to help clinicians predict the severity of the illness.