Feeding UnTied Limited

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This means we looked for evidence the service involved people and treated them with compassion, kindness, dignity and respect.

This is the first assessment for this new location. At our last assessment we rated this key question as outstanding. At this assessment the rating has remained outstanding. This meant people were truly respected and valued as individuals; and empowered as partners in their care in an exceptional service.

We reviewed all 4 quality statements for care. This included, kindness, compassion and dignity, treating patients as individuals, independence, choice and control, and responding to patients’ immediate needs. We found:

The registered manager consistently went above and beyond to ensure primary caregivers fully understood their baby’s condition and felt confident in making decisions about care and treatment. They took time to provide clear, compassionate explanations and tailored support, ensuring families never felt rushed.

People were treated with empathy, kindness and compassion. Interactions were consistently warm, respectful and centred around the needs of both the baby and their caregivers.

Caregivers were involved in all decisions, and their views were actively sought, listened to and valued. The registered manager created an environment where caregivers felt empowered and fully included.

People’s dignity was upheld at all times. The registered manager was sensitive to the emotional needs of families and ensured privacy and respect during assessments and procedures.

Feedback about the service was overwhelmingly positive. Caregivers consistently described the service as “amazing” and “brilliant,” praising the registered manager extensive knowledge and exceptional standard of care.

We have not awarded this service a score for Caring.

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

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity. The registered manager always treated colleagues from other organisations with kindness and respect.

Caregivers consistently told us they were treated with kindness, compassion and dignity. The registered manager was passionate about providing an outstanding service. People we spoke with felt they had received the service they paid for and did not feel the registered manager could do more to enhance their experience. They showed commitment to achieving the best possible and safest outcomes for babies. The registered manager demonstrated a warm and respectful approach, taking time to build positive and trusting relationships with families. The registered manager responded sensitively to people’s anxieties during appointments, offering reassurance and clear explanations. Feedback from those who used the service was consistently positive. One person told us, “The balance between professionalism and warmth was perfect”

Caregivers said the registered manager considered their individual needs, including communication style, and provided education to support people to understand the condition and procedure. The registered manager carried out a comprehensive assessment that included a full feeding history and preferred feeding method, alongside an assessment of both the mother and baby. We were told by one caregiver that they felt the appointment was reaffirming for them and that they were treated in an unpatronizing manner.

The registered manager considered their individual needs and provided education to support people to understand the condition and procedure. One person whose first language was not English told us they felt fully included in their appointment. They said an interpreter was not needed because the “registered manager communicated clearly and checked our understanding”.

The registered manager took time to interact with both the baby and caregivers in a respectful and considerate way, listening to their concerns. We observed the registered manager offering both practical and emotional support to caregivers when needed, including active listening without judgment. They provided reassurance and support to one caregiver who was visibly anxious about the procedure. The registered manager’s tone was calm and supportive, and the caregiver chose the level of involvement they wished to have with the procedure.

During appointments, the registered manager had the blinds closed to uphold privacy when examining breastfeeding techniques. The registered manager explained how she firstly discussed breast feeding and the necessity sometimes to assist with the placement of the child. We were told by one caregiver that the registered manager was very patient and understanding of their cultural circumstances.

During the procedure, we saw gentle handling of the baby and a calm and reassuring tone throughout the procedure. The registered manager explained how personal information would be stored. They offered a clear explanation why a photograph of the baby’s tongue would be taken following the procedure and where this would be stored. They explained the purpose of taking the photograph and confirmed it would not be shared without the caregiver’s consent.

We scored the service as 4. The evidence showed an exceptional standard. The service treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences. The service took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

We interviewed 7 people who used the service. They all reported to have experienced positive outcomes following the procedure and the service met their expectations. One person said the registered manager “helped to improve my breastfeeding experience and I no longer worry about the pain of feeding but look forward to another bonding experience with my baby”. Online reviews from the last 12 months showed 100% of respondents rated the service as excellent. This meant the service consistently provided positive outcomes to people who used the service.

The registered manager was aware of necessary adaptations required when assessing individuals with protected characteristics. The registered manager explained that if protected characteristics were documented on the pre assessment questionnaire, a follow up conversation would be had in order to provide the best care and outcome for those individuals.

When people attended the service, the registered manager adjusted their communication skills as necessary. One caregiver said they had a clinical background, and the registered manager adapted their communication style to reflect this. They also ensured the caregiver’s partner, who did not have a clinical background, was fully included by providing clear explanations of the procedure.

The registered manager had appointment slots for one hour and people said this length of time was long enough to allow them to get all the support needed from the consultation. Some people we spoke with said their appointment time was extended to ensure they left feeling supported and all their questions were answered. One caregiver said the service went “above and beyond” their expectations and the registered manager observed their anxieties with feeding and spent additional time supporting with this.

The service had taken positive steps to support people who did not speak English as their first language. The website included a translation function, which allowed caregivers to access information in 8 different languages. Caregivers were encouraged to attend with family members who could help interpret, so there were no barriers to understanding the appointment. Where this was not the person’s preference, the registered manager confirmed a professional interpreting service could be arranged.

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional at promoting people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

There was information provided about tongue‑tie, feeding challenges and the procedure before the appointment via the website. There were links on the website that provided caregivers with information to support them to make decisions about their care. People were given time to consider the information provided before agreeing to the procedure. One person said the registered manager “provided the pros and cons of undertaking the procedure and we were given as much time needed to make the decision”.

The registered manager used different communication methods as part of the assessment, including a visual check of the baby’s tongue function, so caregivers could decide whether to have the frenulotomy procedure. The registered manager involved caregivers in the consultation and there was a family‑centred approach, with sensitive interactions. The registered manager included caregivers in the decision making, allowing them to choose how they wanted to support and comfort the baby during the procedure.

The caregivers were consistently involved by the registered manager throughout the assessments and treatment process and actively encouraged meaningful interactions and engagement. The service demonstrated flexibility by allowing caregivers to attend with partners, relatives or other supportive adults that the caregiver consented to be present. This ensured people had the emotional support they needed. We observed the registered manager sensitively encouraging caregivers to have a private conversation if they had any doubts or anxieties about the procedure.

The registered manager encouraged caregivers to access community support after the appointment, which included local feeding services. Caregivers were provided with a magazine, which had clear guidance and signposting to baby and toddler groups. The material provided useful resources for the caregivers to access. One person said “information about local support groups and Warwickshire advice services were provided. We really appreciated the level of care.”

One person said they spoke with the registered manager before the procedure to ease their anxieties and clarify concerns they had. People had overwhelming praise for the information provided. One person said “We came away with lots of resources and information as well as follow up contacts. We now have a much happier baby and have been having some super feeds”.

There was a range of appropriate equipment to support and maximise people’s independence and outcomes from care and treatment. People said the service had suitable facilities to meet the needs of their babies, which included a nappy changing area. The service translation including nipple shields, to support caregivers with achieving effective and comfortable feeding where clinically identified.

The registered manager had kitchen facilities at the service, and we saw caregivers being able to use these if needed. The toilet facilities were accessible for people with mobility problems, which showed inclusivity.

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional in how they listened to and understood people’s needs, views and wishes. The practitioner responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

People’s needs, views, wishes and comfort were a priority, and the registered manager quickly anticipated these to avoid any preventable discomfort, concern or distress. The service allocated 30‑minute periods either side of each appointment to make sure consultations were not rushed. The registered manager allowed appointments to run over when needed so additional questions could be answered. The registered manager monitored the baby’s feeding following the procedure and asked questions to the caregiver to assess the effectiveness of the procedure. The registered manager checked the tongue for any bleeding before the appointment had ended.

The registered manager took time to observe, communicate and engage people in discussions about their immediate needs. They responded in the most appropriate way to respect their wishes. People said the registered manager made them feel at ease with how they interacted with them and the needs of the baby.

We saw the registered manager paused during the frenulotomy assessment to allow the baby time to settle and minimise any distress they may have been experiencing. One person said the registered manager “reassured me throughout, explained what would happen, and anticipated every worry I had, even before I said it. I left the appointment feeling amazing, like I was on cloud nine".

The registered manager undertook feeding observations prior to the procedure to immediately identify concerns and complex feeding challenges. When a situation required support beyond the service, the registered manager referred families to the GP or relevant specialist services on the same day. Caregivers were also provided with post‑procedure advice and information if unexpected bleeding or other concerns occurred after the appointment.

We did not look at Workforce wellbeing and enablement during this assessment. There is no previous rating for the Caring key question so we cannot yet publish a score for this area.