This article describes a Dementia Focused Performance Management Programme run for care home managers in the north-west of England. The programme highlighted the challenges faced by managers in terms of complying with policy changes and providing adequate supervision and training for care staff in dementia care. It proposes ‘turn around simulations’ as a way of engaging more participatory approaches to raising standards but recognises the barriers to achieving this created by the limited amount of time that managers have to attend outside meetings and the need to recognise that there is a competitive marketplace among providers.