Feeding Together

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This means we looked for evidence that the service met people’s needs.

This is the first assessment for this service this key question was rated as good. This meant people’s needs were met through good organisation and delivery.

There were 6 quality statements in responsive that we assessed: Person centred care, care provision, integration and continuity, providing information, listening to and involving patients, equity in access, equity in experience and outcomes. We found:

People were included in the decision-making process and provided with evidence-based options.

Systems were in place to advise caregivers of what to expect before the appointment and information was stored safely and in line with data protection.

The complaints process was clear on the website and people felt they could approach the registered manager if they had concerns, confident they would be addressed.

There was an aftercare service in place which provided advice and support for people after the frenulotomy procedure.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

The service made sure babies were at the centre of their care and treatment choices and they decided, in partnership with caregivers, how to respond to any relevant changes in babies needs.

The registered manager checked caregivers understood the condition and provided information about managing potential risks, including bleeding and reducing the likelihood of tongue-tie reformation. Caregivers told us the registered manager was knowledgeable and explained information in a way they could easily understand.

Before attending the appointment, caregivers completed a questionnaire which provided the registered manager with information about the baby's medical history, current health needs, feeding history, medication and any ongoing investigations.

During the consultation, the registered manager built on the information gathered through the pre-assessment by completing a further assessment of the baby's health, feeding history, and mouth and palate anatomy. We observed records and care plans reflected the findings of the assessment and the outcome of the procedure.

People felt involved in discussions about their baby's care. One caregiver told us the registered manager included their partner in the appointment and provided advice on how to recognise whether the procedure had been successful and whether the baby was receiving enough milk.

The service had an exceptional understanding of the needs of babies and caregivers, so care was joined-up, flexible and supported choice and continuity.

The service was flexible and responsive to the needs of caregivers and babies. Appointments were available at a range of times, including dedicated evening and weekend sessions, allowing care to be arranged around family and work commitments. This enabled caregivers to be fully involved in appointments and decision-making.

The registered manager anticipated the support families might require following treatment and put arrangements in place to ensure continuity of care. Caregivers could contact the service by telephone or secure messaging applications, and follow-up home visits were available if requested.

Information on how to access support was included within discharge information. The registered manager's telephone number was provided so caregivers could easily seek advice if concerns arose after the appointment. Follow-up messages were also sent, including links to videos and other resources to support feeding, recovery and ongoing care.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to babies and caregivers needs.

Systems were in place to protect confidentiality and support people's rights and choices regarding information sharing. Consent and information-sharing documentation were stored within the electronic patient record system, and information handling processes complied with data protection requirements. The registered manager had completed Information Governance training and ensured personal information was stored securely.

Caregivers were provided with information in a way that supported their understanding and enabled them to make informed choices about care and treatment. Before their appointment, caregivers could access information on the service website about tongue-tie, feeding difficulties and treatment options. This included links to resources produced by the Association of Tongue-Tie Practitioners (ATP), with information and images explaining tongue-tie, its potential effects and available treatments.

We observed the registered manager explaining assessments, procedures, risks, benefits and alternative options in a way families could understand. Information was tailored to individual needs, and practical demonstrations, including the use of a doll, were used to support discussions about feeding techniques. Written information was also shared with caregivers to reinforce key information discussed during appointments.

The website provided clear information about the services available, associated costs and the process followed when an assessment identified a tongue-tie division was not required.

We saw clinical records were completed promptly following appointments and included clear rationale for decisions made, along with details of aftercare advice provided. Caregivers could request copies of their records following the appointment.

The service made it easy for caregivers to share feedback and ideas, or raise complaints about their care, treatment and support. They involved caregivers in decisions about their care and told them what had changed as a result.

The service had an up-to-date complaints policy in place. Information was available for caregivers who wished to escalate concerns, including cards containing details of how to contact the Care Quality Commission (CQC).

The service had not received any complaints during the previous 12 months. Although the registered manager had not received suggestions for improvement from caregivers, they were able to explain how feedback would be reviewed and used to improve the service.

The service made it easy for caregivers to raise concerns or provide feedback. An online email link was available on the website, alongside information explaining how complaints would be investigated, the steps taken if concerns could not be resolved, and how learning would be identified from complaints.

Caregivers described the registered manager as approachable, professional and willing to listen. Caregivers told us they felt confident any concerns would be taken seriously. The registered manager responded to questions received after appointments where people required additional advice or support.

The service made sure that caregivers could access the care, support and treatment they needed when they needed it.

Caregivers could access the service in a range of ways, including through an online referral form, by telephone or via social media. Caregivers told us the booking process was straightforward and easy to use. The online booking system gave families the opportunity to identify any reasonable adjustments they required before attending their appointment.

The service was flexible in responding to the needs of caregivers and babies. Appointments were offered promptly, and the registered manager adapted appointment lengths where necessary to allow additional time for babies with complex feeding difficulties or when caregivers required further information and support.

Families were provided with clear information before attending appointments, enabling them to consider their options and make informed decisions about care and treatment. Appointments could also be arranged around work and family commitments to support caregiver involvement.

The registered manager actively listened to information about caregivers who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The registered manager had completed mandatory equality, diversity and human rights training and demonstrated an understanding of the needs of different groups accessing the service.

The service monitored clinical outcomes to ensure care was achieving positive and consistent results that met both clinical and non-clinical expectations.

Equality and diversity principles were supported through the registered manager's training and awareness of underrepresented groups who may access the service. This helped ensure care was delivered in a way that considered individual needs and circumstances.

We did not look at Planning for the future during this assessment. There is no previous rating for the Responsive key question so we cannot yet publish a score for this area.