During an assessment under our new approach
About the service
Hillcrest Residential Home is based in Tyldesley, Greater Manchester. The home is registered to provide accommodation for up to 17 people who require personal care and support. At the time of the assessment, 11 people were living at the home.
Who the service is for
The service supports older people and people living with dementia.
Our view of the serviceWe carried out this assessment between 24 August and 10 September 2026. This service was previously rated as good. We carried out this assessment to confirm whether the rating of good remains accurate. This report does not provide detailed information on areas where we found practice continues to meet a good standard. Instead, our findings focus on any areas where the service needs to improve.
Prior to this assessment commencing, the previous owner sold their business, which included Hillcrest Residential Home. CQC were not informed of this in advance and only found out when we arrived for our initial site visit and was told by the registered manager. The new owner’s representative told us they were still engaged in a formal handover process with the previous owner but agreed to register as the new nominated individual as soon as possible. The registration process was finalised prior to this report being completed. Due to the recent change in ownership, any reference to the provider within this report, relates to the previous owners, unless otherwise stated. The new owner has chosen to keep the same provider name and regulatory history, to ensure continuity.
Improvements were required with staff training, staff recruitment processes, the assessment of risks to people and the environment and the management of medicines. Training records showed gaps in completion rates across the staff team. Gaps in employment history had not been explored. Risk assessments were not always reviewed or updated timely. Safety and equipment checks were not always completed, and some required equipment was not in place or fit for purpose. People had sometimes missed doses of their medicines and administration guidance for staff needed strengthening. There were effective systems in place to safeguard people from abuse, with local authority reporting procedures followed. Accidents and incidents were documented consistently, with timely actions taken. The home was clean with effective infection control processes in place.
Monitoring charts to evidence care had been provided had not been completed consistently. Some assessments used to monitor risks and identify care needs, had not been reviewed or updated regularly. Assessments had been completed prior to admission, to ensure the home could meet people’s needs. People had regular and ongoing access to a range of medical and therapy professionals, to help them stay well. Information was shared with other organisations to ensure people’s care was consistent when they moved between services, such as attending the hospital. People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that staff and management worked within the MCA. DoLS authorisations were appropriately applied for and overseen. People were not subject to unlawful or excessive restrictions meaning they had choice, control and freedom over their lives.
Care staff treated people with kindness, compassion and dignity. Staff understood their responsibilities in promoting independence and offering people choices. Staff told us people could choose what to wear, what to do each day, what to eat and drink. When providing care, staff encouraged people to do as much for themselves as possible. People were treated as individuals, with their specific needs identified and supported.
The activity programme required improvement, as limited options were provided each week and engagement was dependent on how busy the staff were. Care plans were detailed and explained people’s needs, though were not easy to follow as some sections were repetitive. Feedback on care and the home overall was sought through meetings and bi-annual surveys. The last survey had been circulated in April 2026 with feedback overall being positive. People’s rights to be treated equally and fairly were being met. People’s protected characteristics were respected and care provided in line with their needs and wishes.
Audit and governance processes were not robust. Limited checks had been carried out, none of which had identified all the issues we found. Learning from incidents was limited. The registered manager was well thought of by people and staff. However, they had received limited support from the provider to ensure the home was meeting required standards, which was reflected in our findings. The new provider sent us an action plan after the site visit to indicate what steps were being taken to drive improvements and ensure management were supported effectively. The home had formed links with a range of professionals as well as a local school, who visited regularly during term time to spend time with people and promote inter-generational engagement.