BACKGROUND This second in a three part series on dementia care explores different approaches to care; part 1 examined communication issues. Dementia care traditionally uses a medical approach to management, which focuses on the standard neurogenic disease paradigm, but now many care home staff and health professionals are moving towards a person centred approach, based on biopsychosocial explanations. OBJECTIVE This study sought to examine the extent to which care home staff have adopted a person centred approach. METHODS Focus groups were carried out with 36 direct care staff from nine care homes. RESULTS The study found evidence that both models of dementia care were in use. Three homes mainly used the medical approach, four the person centred approach and two were moving towards the latter. CONCLUSIONS Training in biopsychosocial approaches to managing challenging behaviours in dementia is needed for care home staff, family and other health professionals.