Publication reference: PR1486

More people cared for at home and less people in hospital

Dynamic support registers (DSRs)

• For adults, children and young people.
• A tool used in a local area to identify people at risk or those who may become at risk of admission to a mental health hospital setting without specific and timely dynamic support.
• Each person is given a red, amber or green rating dependent on risk – or blue, a separate rating identifying those children, young people and adults currently in inpatient services. 

Care (Education) and Treatment Review (CETR)

• For adults, children and young people.
• A meeting to talk about people at risk of going into a mental health hospital and who are already
  in a mental health hospital.
• Makes sure the person and their family are listened to.
• Makes a plan to support people to get the treatment they need.
• Each time a C(E)TR takes place, a review of the red, amber or green rating on the DSR takes place.
• A record of C(E)TR recommendations kept on the DSR record.
• The dynamic support risk stratification process should include a review of community C(E)TR
  recommendations and inpatient C(E)TR recommendations for people at risk of readmission.

Keyworkers make sure that children, young people and families get the right support at
the right time and that local systems are responsive to fully meeting the young people’s
needs in a joined up way. More information about keyworkers can be found on the NHS England website:
www.england.nhs.uk/learning-disabilities/care/children-young-people/keyworkers

Red rating: Immediate risk of person being admitted to a mental health hospital

• A C(E)TR must take place.
• Referral to the keyworker service for children and young people.

Amber rating: Immediate risk that the person will be admitted to a mental health hospital without urgent intervention

• A multi-agency meeting and/or C(E)TR must take place.
• Referral to the keyworker service for children and young people.

Green rating: Some risks that could lead to the person being admitted or re-admitted to a mental health hospital but currently these risks are being effectively managed

• Clear identification of partners who would need to be involved in a C(E)TR if required.

Blue rating: Identifies children, young people and adults currently in mental health hospitals

• Use to identify people needing commissioner oversight visits and inpatient C(E)TRs.