Ms Julienne Espineli

Updated 14 September 2022

Julienne Espineli is owned and operated by Ms Julienne Espineli. The provider offers tongue-tie services in the greater London region. 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 in order to release the tongue, which is known as a frenulotomy.

The provider assesses the tongue function and feeding ability prior to carrying out frenulotomy procedures. The provider is qualified to provide frenulotomy divisions for babies up to the age of six months. Older babies or those with complex needs are referred to the local NHS team or to the patient’s GP.

The service has been regulated by the CQC to undertake the regulated activity of surgical procedures since 10 June 2019. The provider is the clinician who carries out the regulated activity. Ms Espineli a registered nurse and is registered with the Nursing and Midwifery Council. She is registered with the International Board of Certified Lactation Consultants (IBCLC) for feeding and is listed as an approved independent tongue-tie practitioner with the Association of tongue-tie practitioners (ATP). In addition to the frenulotomy service, the provider offers baby feeding and lactation support services, which are not regulated by CQC. Appointments are offered in people’s homes.

From 1 January 2021 to 31 December 2021, the provider carried out 135 frenulotomies.

Updated 14 September 2022

We carried out an inspection of Julienne Espineli using our comprehensive methodology on 8 August 2022 and 12 August 2022. The service had 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:

• Feedback we received from parents was extremely positive. The service was inclusive and took account of parents’ individual needs and preferences.
• The provider 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 provider followed national guidance and evidence-based practice. There was evidence of quality monitoring through regular clinical audits.
• A comprehensive assessment was completed for each patient including a feeding assessment and assessment of risk.
• The provider kept detailed records of patients’ care and treatment.
• The provider supported primary care givers to make informed decisions about their baby’s care and treatment. The process of seeking and recording consent was thorough and included sufficient information to allow for informed decisions to be made.
• There was a high level of aftercare available to primary care givers following the procedure. The provider treated parents and their babies with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.
• Primary care givers could access the service when they needed it. Services were offered seven days a week.
• Leaders had the skills and abilities to run the service. The service had a vision for what it wanted to achieve and a strategy to turn it into action.
• Systems to manage performance had been implemented. Risks were identified and actions to reduce their impact were listed on the service’s risk register.
• The provider was committed to continual learning and improving their service. They understood the skills required to make improvements and they shared information for research and to innovate future services.

Updated 14 September 2022

The service had not been previously inspected or rated. During this inspection we rated it as good. See the summary above for details.