Why are nursing and residential homes so fascinated by round circles? Time and time again in many of the homes I have visited, in and around Sussex and Kent, I am surprised to find ‘residents’ sitting in lounges in round circles, dozing or staring aimlessly with a television blaring in the background. Is this the continuing future prospect for residential services? Please spare me from such a prospect as I inevitably near old age!

When we take on a contract one of our aims is to help the home develop a sense of personhood, a culture where the person is an individual to be helped as wished and needed. A culture where it is understood that the individual is renting a room, a tenant approach, and we (staff or visitors) are their guests. A culture where it is understood that they are employing us - no ‘residents’ no ‘job’. Why is it so hard to achieve? We all want to be loved, valued, respected and listened to. Why should people be treated differently once they leave the safe haven of their home to enter a establishment because they need a little extra help?

As yet I have not been in a private residence where sitting rooms aren't arranged in a round circle of sofas and chairs decorate the walls. Well mine certainly doesn't. Where did this circle syndrome originate? Time and time again I rearrange chairs and sofas in tête-à-tête groups. No sooner do I leave the room a member of staff will organise the room in a circle. When challenged I am met with ‘Mrs so and so got upset, she likes to sit in her chair and gets upset if it moves’. Has the circle become the entrenched entertaining arena of care home life? An observational point for staff, visitors and other ‘residents’ charades.

Last week, I visited a lovely lady who had recently entered a residential home to recover from a fall she suffered at home. A very witty intelligent lady with some memory loss and confusion. Sadly, she is getting desperately frustrated, fed up and more confused, isolating herself in her room. Why? Carers are kind, getting her cups of tea and biscuits in her room and helping her when she needs help but there is no stimulation, no engagement, nothing to do and has nothing in common with (in her own words) other ‘inmates’. She is not ready yet to stare at others’ drooping faces or ‘catching flies’ sitting in a circle. "It's very depressing" she said. She does not like to venture outside of her room in case she bumps into other ‘inmates’ who are ‘gaga’. How sad to be moulded into a ‘resident’ mode. As we chatted the conversation became more interesting, her speech and thoughts became clearer. We went for a short walk, a brief escapism from her present reality. She wanted to demonstrate her independence and how well she was walking. She is not ready to be institutionalised and she's certainly not ready to be initiated into the ‘round circle syndrome’.