The Care Quality Commission (CQC) has rated D-Restricted Ltd as outstanding following its first inspection in February.
D-Restricted Ltd, run by a company of the same name, is a single specialty service providing tongue tie assessments and procedures for infants across Coventry, Warwickshire, Leicestershire and Derbyshire.
Tongue tie, also known as ankyloglossia, is a condition where the strip of skin (frenulum) connecting an infant’s tongue to the bottom of their mouth is shorter, thicker or more inelastic than usual. Some infants require a surgical intervention to release the tongue, which is known as a frenulotomy.
In 2025, D-Restricted Ltd carried out 339 assessment and frenulotomy procedure appointments and 48 assessment-only appointments.
CQC carried out an announced inspection of the service as part of its first inspection under its current registration. Inspectors gave short notice to ensure the registered manager was available so they could observe care and treatment, as the manager is the sole practitioner at the service.
CQC has rated how caring, responsive and well-led the service is as outstanding, and how safe and effective it is as good.
Carolyn Jenkinson, CQC’s deputy director of hospitals in the west midlands, said:
“During our inspection of D-Restricted Ltd, we found an exceptional service that put infants and their caregivers at the heart of their care. This helped the service provide exceptionally personalised support that promoted independence. The registered manager’s approach was resulting in positive outcomes for the families they supported.
“People whose infants had received care were overwhelmingly positive about their experiences. They told us they highly valued the support they received before, during and after care and treatment, and were positive about the manager’s knowledge and approach. The manager had a calming approach to supporting infants, which helped minimise distress and put everyone at ease.
“We saw the service treat people with kindness, empathy and compassion, while listening to their needs, views and preferences. The manager responded to infants and their caregivers’ needs promptly to address any discomfort or concerns.
“It was clear the manager fully assessed people’s health, wellbeing and communication needs to ensure their care and treatment was effective. They kept care under close review and identified people’s outcomes clearly, and ensured they worked in partnership with families to provide personalised care.
“Following treatment, the manager provided families with a personalised feeding plan, access to online resources and follow up appointment opportunities. Caregivers were consistently positive about this post-care support and how it improved their infant’s health and family wellbeing.
“D-Restricted Ltd should be very pleased with the many positive findings in our report. It was encouraging to hear how delighted families were with the service and care provided.”
Inspectors found:
- D-Restricted Ltd worked in partnership with other services to provide safe care and support to ensure people had consistent experiences of accessing help and support.
- The manager was qualified, skilled and experienced in carrying out the relevant surgical procedures.
- Healthcare professionals told inspectors the services provided invaluable support to families, who were positive about their experiences.
- The manager focused on continuous learning and innovation to improve the services and enhance people’s experiences of care. They reported safety events and actively listened to concerns, with processes in place to investigate incidents.
- The service put reasonable adjustments in place when caregivers faced barriers to attending the clinic, and the manager offered home assessments when needed.