Background to this inspection
Updated
16 June 2022
The provider offers tongue-tie services within the Northamptonshire area. Tongue tie, also known as ankyloglossia, is a condition where the strip of skin connecting the babies’ tongue to the bottom of their mouth is shorter than usual. Some babies require a surgical intervention to release the tongue, which is known as a frenulotomy. The provider carries out assessments of tongue function and feeding assessments prior to carrying out frenulotomy procedures.
The provider is qualified to provide frenulotomy divisions for babies up to the age of one year. Divisions on older babies with teeth are referred to the local NHS team or to the patient’s GP.
The service has been regulated with the CQC to undertake the regulated activity of surgical procedures since 1 August 2019. The registered manager is a sole trader and is the clinician who carries out the regulated activity. They are a registered midwife and registered with the International Board of Certified Lactation Consultants (IBCLC) for feeding. They are listed as an approved independent tongue tie practitioner with the Association of Tongue Tie Practitioners (ATP).
In addition to frenulotomy, the provider offers baby feeding and lactation support as well as sleep advice, which are not regulated by the CQC.
The service offers appointments in peoples home only and offers up to 10 appointments per week. Bookings are taken over the telephone. Appointments offered are for assessment of the tongue and surgical division procedures. These are normally undertaken within the same appointment.
From 1 April 2021 to 31 March 2022, the provider carried out 342 frenulotomy procedures.
Updated
16 June 2022
We carried out an inspection of Louise Field Consulting using our comprehensive methodology on 26 April 2022. The service has not been previously inspected.
Our inspection was announced. We gave the provider short notice of the inspection date to ensure their availability on the day.
This was the first time we inspected the service. We rated it as good because:
- The registered manager was up to date with mandatory training and had the right qualifications, skills, training and experience to keep patients safe and to provide the right care and treatment. The registered manager understood how to protect patients from abuse. The service generally controlled infection risk well. A comprehensive assessment was completed for each patient including a feeding assessment and assessment of risk. Staff kept detailed records of patients’ care and treatment.
- The service followed national guidance and evidence-based practice. The registered manager supported primary care givers and legal guardians to make informed decisions about their baby’s care and treatment.
- There was a high level of aftercare available to primary care givers following their procedure. The registered manager treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.
- The service was inclusive and took account of patients’ individual needs and preferences. People could access the service when they needed it. Services were offered seven days a week.
- It was easy for people to give feedback and raise concerns about care received. Feedback from primary care givers was consistently positive.
However:
- At the time of our inspection, the registered manager did not dispose of clinical waste and sharps used during the procedure in appropriate clinical waste at the point of care. This meant staff did not always control infection risk well.
- At the time of our inspection the service policies and procedures were not personalised to the service. Systems to monitor the effectiveness of care and treatment were not fully embedded. Governance processes were in place, although they were not fully embedded.