On the Dynamic Support Register?

A Guide for Families on Strengthening Support at Home Before Crisis
If your child, sibling, or loved one has been placed on the Dynamic Support Register (DSR), it can feel frightening.

You may start hearing new phrases like “risk of admission.” You might notice more professional meetings. You may even hear hospital being mentioned as a possibility.
Take a breath.
Being on the Dynamic Support Register does not mean hospital admission is inevitable.
The DSR exists to identify people with a learning disability and/or autism who may be at risk of admission to a mental health hospital, so that extra support can be put in place early to prevent crisis.

The keyword is prevent.
For families, the real question becomes:
What community support is being strengthened right now to keep my loved one safe at home?
What Should Happen When Someone Is On the Dynamic Support Register?

When someone is added to the DSR, there should be clear and proactive action, not just monitoring.

You should expect:

A Care (Education) and Treatment Review (C(E)TR)
An updated crisis plan
Multi-agency involvement
Clear alternatives to hospital admission
A focus on reducing restrictive practices

If conversations are becoming more focused on “risk” without practical increases in home support, this is the time to ask what additional community provision is being explored.

Hospital admission often follows a period of instability or breakdown in support. Acting early can change that path entirely.
How Community Support Can Prevent Hospital Admission

Strong, personalised support at home is one of the most effective ways to prevent unnecessary hospital admission for autistic people and people with learning disabilities.

This means:
Consistent, trained support staff
Clear routines and structure
Clinical oversight where needed
Resilient staffing to prevent gaps
A coordinated care framework

When support is fragile, risk increases. When support is strengthened, stability grows.

That is where the Genesis service from HomeCareDirect plays a crucial role.

The HCD Genesis Model: Preventing Crisis and Supporting Safe Discharge

The HCD Genesis Model is a national secure-unit discharge and admission-prevention service designed to help people with complex autism and learning disabilities with associated mental health conditions remain safely in the community.

It supports individuals who:
Are at risk of hospital admission
Are being discussed within DSR processes
Require Section 117 discharge planning
Need highly coordinated, bespoke support at home

Genesis focuses on one central aim: Keeping people safe and supported at home, wherever possible.

 What Makes the Genesis Model Different?

1. One Accountable Provider

Genesis operates as a single-management model.

Instead of fragmented care across multiple agencies, one organisation is responsible for:
Recruiting the support team
Training staff to CQC standards
Providing oversight and quality assurance
Coordinating clinical input
Ensuring compliance and continuity

For families, this means clarity. You know who is accountable.

2. Personalised Support, Built Around Your Loved One

Genesis does not place someone into a pre-existing service model.

It starts by listening.

The team works with:
The individual
Family members
Clinical professionals

Together, they identify strengths, risks, daily routines, and what a meaningful life looks like for that person.

Support hours, skill mix, and any waking-night requirements are carefully assessed to ensure safety and consistency.

3. Involving Families in Building the Team

One of the most reassuring elements for families is involvement in the recruitment process.

With commissioner agreement, the person and their family can:
Help select support staff
Include trusted local carers
Even consider family members within the team where appropriate

This collaborative approach increases trust and stability, both of which are protective factors when someone is on the DSR.

 4. 24/7 Resilience

A common reason for crisis escalation is fragile staffing.

Genesis builds in resilience by ensuring:
24-hour coverage where needed
Waking-night support if assessed
Back-up and relief staff
Out-of-hours support systems

This reduces the risk of breakdown in care provision, a key concern for families worried about hospital admission.

 5. Ongoing Review and Improvement

Support is not static.

Genesis includes:
Ongoing multidisciplinary review
Clinical oversight
Coaching and development for staff
Regular evaluation of what is working

This keeps support aligned with changing needs and reduces the likelihood of crisis developing unnoticed.

 Why Early Action Matters for Families

If your loved one is on the Dynamic Support Register, this is the moment to ask:
What additional community support is being funded now?
Has a bespoke support model been explored?
Is there a clear plan to prevent hospital admission?
Is the current staffing resilient and clinically overseen?

Waiting until crisis escalates reduces options.

Early intervention increases them.

Models like the HCD Genesis service demonstrate that structured, well-managed, personalised home care can:
Support safe Section 117 discharge
Prevent hospital admission
Provide clarity in complex cases
Improve quality of life through stable relationships and routine

For many families, the biggest fear is losing control of decisions once hospital is mentioned. Proactive, coordinated community care keeps the focus on stability — not escalation.

 A Message to Families Feeling Anxious

If you are feeling worried because of DSR involvement, you are not alone.

The register should be a signal that support needs strengthening, not a sign that detention is inevitable.

With the right framework in place, people with complex autism and learning disabilities with associated mental health conditions can remain safely in their homes and communities.

The key is to act early, ask clear questions, and ensure a structured, accountable support model is in place.

The HCD Genesis Model offers one example of how hospital admission can be prevented through:
Personalised planning
Skilled recruitment
Coordinated oversight
24/7 resilience
Collaborative partnership with families

Because crisis prevention is not about watching risk increase.

It’s about strengthening support before it’s too late.