• The development of practice is but one aspect of Clinical Nurse Specialists' (CNSs) work, and a number of factors act to shape the extent to which CNSs are able to work with and develop practice with nursing and residential care homes. • A postal survey of 730 community CNSs in palliative care working in the UK was undertaken to explore the involvement of these nurses with nursing and residential care homes. • Much of the focus of the involvement was reactive work meeting the direct clinical needs of residents, primarily with cancer. • Although the CNSs perceived that there were some educational and care deficits in these care settings, the amount of proactive work undertaken to improve practice was limited. • The development work undertaken was focused on educational initiatives and establishing link nurse systems. • There is potential to develop palliative care practice in nursing and residential care homes through practice development initiatives.