A hospital named and shamed for poor hygiene in a television documentary is still failing to take cleanliness seriously, according to its own staff.
Almost half of NHS workers at the trust responsible for Heartlands Hospital in Birmingham say managers are not doing enough to promote the importance of hand-washing.
Last night hospital managers said every member of staff was informed about the importance of hygiene and they were "shocked" by the finding.
It was revealed by independent watchdog the Healthcare Commission.
The trust, Heart of England NHS Foundation Trust, runs Heartlands Hospital and Solihull Hospital.
A BBC documentary last year found that some cleaners at Heartlands were failing to follow procedures for cleaning wards, isolation rooms and toilets.
Since then the hospital has tightened up procedures and cut infection rates of the MRSA superbug by 30 per cent.
It was also the launch site of a Royal College of Nursing campaign to wipe out MRSA.
But the new survey found that 47 per cent of workers at the trust disagreed or strongly disagreed with the statement that their health trust did enough to promote the importance of hand-washing.
The same number said they believed the trust did do enough, and the remainder did not know.
Staff were also concerned at the Royal Shrewsbury Hospital and Telford Hospital, in Shropshire, where 54 per cent of staff said their health trust failed to promote the importance of hand washing.
And at Good Hope Hospital, in Birmingham, 37 per cent of staff said the same thing.
However, workers in most hospitals said hygiene was taken seriously.
For example, 82 per cent of staff at the Queen Elizabeth Hospital in Birmingham, which has also been criticised for a high MRSA rate, said their trust promoted hygiene effectively, and only nine per cent disagreed.
Across the country as a whole, nine per cent of hospital staff said they disagreed with the statement "the trust does enough to promote the importance of hand washing to staff".
The same survey found 61 per cent of Heartlands staff reported hygiene materials such as hot water, soap and alcohol rubs were "always available when needed".
But 33 per cent said the materials were only available sometimes, even when needed.
Dame Jill Ellison, Director of Nursing for Heart of England NHS Foundation Trust, said: "Every member of staff in the Trust has access to infection control information via the intranet site.
"In addition, there is a bright yellow infection control manual in every ward and clinical department, so staff who do not use computers can check all the relevant guidelines.
"Infection control training is carried out once a year, for all staff who care for patients.
"Last year the trust also issued six golden rules of infection control, which went out with every single pay slip, and an attached form that staff signed to say they agreed to abide by the rules."
She added: "We take this very seriously and are incredibly shocked by the results of this survey."