Feeding UnTied Limited

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This is the first assessment for this new location. At our last assessment we rated this key question as good. At this assessment the rating has remained good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

We assessed all 5 quality statements for well led: shared direction and culture, capable, compassionate and inclusive leaders, diversity and inclusion, governance, management and sustainability, partnerships, communities, and learning, improvement and innovation.

The registered manager had the skills and abilities to run the service. They had processes to support people remotely. The registered manager had undertaken equality diversity and inclusion training. There were policies and processes to ensure the service was inclusive and fair.

The provider had a clear vision and strategy for the service, which described a culture of honesty, kindness and supportive care. The service engaged with GPs and signposted people to the local community to improve the care they provided.

The registered manager showed evidence of continuous learning and sharing of knowledge with colleagues locally and in the Association of Tongue-tie Practitioners (ATP).

We have not awarded this service a score for Well-led.

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

We scored the service as 3. The evidence showed a good standard. The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities

The service ensured there was a shared vision and strategy. The registered manager demonstrated a positive, compassionate, listening culture that promoted trust and understanding between them and people using the service and was focused on learning and improvement. The registered manager received praise from people who used their service. People described the registered manager as being compassionate, who listened attentively, and took time to understand their concerns. People said their questions were answered and advice was helpful and reassuring during their appointment. One person said, “my concerns and anxieties were truly heard.”

The registered manager had a well-developed understanding of equality, diversity and human rights, and they prioritised safe, high-quality, compassionate care. The service’s policy promoted equality, diversity and human rights.

There were processes in place to review policies within the service. The registered manager ensured there was an inclusive culture throughout the service, and people received safe, high‑quality and compassionate care.

We scored the service as 4. The evidence showed an exceptional standard. The service had exceptionally inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They always did so with integrity, openness and honesty.

The registered manager had the experience, capacity, capability and integrity to ensure that the organisational vision could be delivered and risks were well managed. The registered manager was a qualified Midwife and Nurse and an International Board-Certified Lactation Consultant (IBCLC). The registered manager had the skills, knowledge, experience, and integrity needed to lead and run the service effectively. They had oversight of the service’s risks and completed audits in line with their policies and procedures. There was overwhelming praise from people we spoke with who felt they had an excellent knowledge of tongue-ties, which they could clearly explain. The registered manager updated the organisations risk assessment in February 2026 and was aware of the risks and actions to manage these.

The registered manager was knowledgeable about issues and priorities for the quality of the service and could access appropriate support and development in their role. The registered manager had a strong understanding of the priorities involved in delivering a high‑quality tongue‑tie service, including effective assessment, feeding support, and clear follow‑up processes.

The service had policies and procedures aligned with national guidance. The registered manager showed a clear understanding of the challenges the service had encountered and recognised the practical constraints that had limited some of the improvements they hoped to make. They maintained oversight of these factors and continued to look for opportunities to develop the service where possible.

We did not look at Freedom to speak up during this assessment. There is no previous rating for the Well-led key question so we cannot yet publish a score for this area.

We did not look at Workforce equality, diversity and inclusion during this assessment. There is no previous rating for the Well-led key question so we cannot yet publish a score for this area.

We scored the service as 3. The evidence showed a good standard. The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

There were clear and effective governance, management and accountability arrangements. The service understood their role and responsibilities. The registered manager had effective governance processes. The service policies and procedures were relevant to the service and in-line with the ATP and national guidance. The service had appropriate indemnity arrangements to cover all potential liabilities, including professional and public indemnity insurance.

Data or notifications were consistently submitted to external organisations. The service had clear processes for reporting incidents and sharing relevant information with the ATP, who maintained oversight of this activity. Local monitoring systems were also in place to ensure reporting remained accurate, timely and compliant with expected standards.

There were robust arrangements for the availability, integrity and confidentiality of data, records and data management systems. Information was used effectively to monitor and improve the quality of care.The registered manager was aware of their responsibilities under General Data Protection Regulations (GDPR) and how it related to the privacy of the baby and primary caregivers. There was an in-date GDPR policy embedded in the service. The registered manager reviewed email responses, complaint forms, google reviews and verbal suggestions as part of their reflective practice to improve the experience of people using the service. They were able to use their data management system to produce pie charts which supported the review on internal data. The registered manager had an in-date data protection registration certificate.

The service implemented relevant or mandatory quality frameworks, recognised standards, best practices or equivalents to improve equity in experience and outcomes for people using services and tackled known inequalities.

The registered manager followed recognised guidance, including the NICE standards relating to consent, audit, and clinical governance and the Accessible Information Standard and the Equality Act (2010). This helped make the service fair, easy to access and people received information in a way that suited their needs.

The registered manager attended satellite group meetings and the annual meeting for tongue‑tie practitioners, which provided updates that informed policy and procedural changes. They also undertook study days and participated in professional forums where clinical care, national policy updates and local and national guidelines were discussed and reviewed.

The registered manager carried out annual reviews and a competency assessment from a peer as part of their professional development.

Processes were in place to ensure the registered manager could demonstrate they were a fit and proper person and were suitably trained. The registered manager had an annual enhanced disclosure and barring service check. They had the correct qualifications, skills, training and experience to undertake the tongue-tie procedure. For example, the registered manager was a Registered Midwife, Nurse and an International Board-Certified Lactation Consultant (IBCLC).

We scored the service as 3. The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The registered manager was open and transparent, and collaborated with relevant external stakeholders and agencies. The service routinely shared relevant information with the GP and health visitor after each appointment. There was also close collaboration with midwives, lactation advisers, and other specialists, depending on additional support needed following appointments.

The registered manager worked collaboratively with local parent groups, providing advice and delivering educational talks to raise awareness of feeding difficulties associated with tongue‑tie.

The registered manager had previously served as a committee member for the ATP, contributing to the oversight of safe and effective practice and supporting fellow practitioners by sharing knowledge and developing their skills.

We scored the service as 3. The evidence showed a good standard. The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

There were processes to ensure that learning happened when things went wrong, and from examples of good practice. The registered manager reported service learning externally to ensure transparency and independent oversight of risk. They had effective systems in place to share information with external bodies and to demonstrate openness in how risks and incidents were reviewed. In addition, the registered manager had established a structured process for seeking feedback from peers through observation and professional discussion. This peer‑review approach helped to validate practice, support reflective learning, and identify opportunities for continuous improvement.

The registered manager ensured that people using the service, their families and carers were involved in developing and evaluating improvement and innovation initiatives. The registered manager continually reviewed and improved the service by using feedback gathered through streamlined communication systems within a database. The introduction of automated follow‑up emails enabled all correspondence to be stored within each client’s record, allowing the registered manager to easily monitor and act on comments, concerns and suggestions. Caregiver feedback was routinely reviewed and used to inform ongoing improvements.

The service had a good understanding of how to make improvements happen. The approach was consistent and included measuring outcomes and impact. The registered manager kept their practice up to date by engaging with new research, guidance and shared learning through the ATP. They regularly reviewed feedback from families and used this as part of their reflective practice and service improvements. Improvements have included clearer directions to the clinic, improved information-sharing processes, a review of reformation age, updated healing review parameters, refined wording of consent forms, and improvements to the booking process.