Organizational structure & Quality

De Drie Notenboomen BV

De Drie Notenboomen is a company with limited liability in sole ownership of Loek Winter. The Executive Board of De Drie Notenboomen comprises Roger Lof and Meile Salverda. Chantal Weijers is director of Stichting Onroerend Goed DDN (the DDN Real Estate Foundation), of which Loek Winter and Anke Blokhuis are trustees.

De Drie Notenboomen is not a healthcare provider in the meaning intended by the Healthcare Quality, Complaints and Disputes Act 2016 (Wkkgz) but its individual franchisees are. This means that they are responsible for the quality of all aspects of the care provided and for the welfare of their residents. As franchisor, De Drie Notenboomen is responsible for the quality of the franchising organization and that of the various franchise formulas.

Stichting Onroerend Goed DDN

Since 1 January 2020, all financial flows pertaining to estate and buildings have been channelled through Stichting Onroerend Goed DDN (DDN Real Estate Foundation; SOG DDN). This arrangement ensures that income and expenditure are fully transparent. Further information about SOG can be found below. The foundation has its own Board of Representatives, a consultation body comprising representatives of the Thomashuizen and Herbergier franchisee associations. All staff involved with real estate management are employed by SOG DDN.

The organizational structure of De Drie Notenboomen, including Stichting Onroerend Goed (SOG) DDN is shown below.

The franchise formulas

Franchisees operating the various formulas developed by De Drie Notenboomen are independent healthcare entrepreneurs with the legal status of a ‘Vennootschap onder Firma’ (general partnership, VOF). They have a contractual relationship with De Drie Notenboomen.
Each year, De Drie Notenboomen conducts a benchmark to provide information about the revenue, expenditure and operating results of the individual locations. The benchmarks for 2020, 2021 and 2022 are shown here.

De Drie Notenboomen holds ISO 9001:2015 certification, issued on 20 August 2018 by Bureau Veritas Certification Nederland and valid until 6 February 2024. Accreditation is subject to annual review.

At the request of De Drie Notenboomen, Bureau Veritas audited the organization’s management system based on a random sample and information derived from various Thomashuis locations. The assessment examined compliance with the ISO 9001:2015 standard itself, legislative and internal quality requirements, client requirements and those of other stakeholders. 

Safeguarding the quality of the franchise formulas is a joint responsibility of the franchisor and franchisees. Both have a part to play in ensuring that residents have a comfortable home with access to high-quality care.

• The franchisee does so by creating a homely environment and offering good care to residents. 
• The franchisor does so by structuring support services with appropriate resources, training and advice, and by facilitating a ‘learning network’ of franchisees. 

Various instruments are used to maintain the quality of the franchise formulas.

Formula handbook

Each franchise formula has a handbook in which its mission and vision are translated into practical measures to be implemented by the care entrepreneurs. The handbook is made available to all franchisees and is regularly updated to ensure the ongoing relevance of the formula. The sections relating to practical care aspects are compiled in consultation with the committees of the franchisee associations. 

Training and peer supervision

Various training opportunities are available for all franchise formulas, whereby a distinction is drawn between experienced care entrepreneurs and those just starting out. Training courses are subject to ongoing development in line with the requirements of the franchise operators and any changes in legislative requirements. Within each formula, franchisees are encouraged to share knowledge and experience through a system of peer supervision.

ARGO

De Drie Notenboomen has retained the services of ARGO, an external research consultancy affiliated with the University of Groningen, which specializes in the quality of health and welfare services. For each of the franchise formulas, ARGO has devised a long-term assessment programme designed to monitor residents’ quality of life. The results support discussions between staff and client representatives with a view to enhancing quality yet further. 

Thomashuis quality framework

The Thomashuis formula is subject to a quality management system which is part of the ISO certification process and is used to evaluate the ongoing validity of the resultant accreditation. It is partly due to this quality management system that the formula is able to maintain full ISO certification. The system confirms the continuity and quality of DDN’s service provision while also demonstrating that all Thomashuis locations comply in full with current legislation. 

Herbergier quality framework

The Herbergier formula applies a separate quality framework that has grown out of the concept’s vision and mission. It is based on a modified version of the standard quality framework for nursing home care. All Herbergier locations are subject to a two-yearly audit to ensure ongoing compliance with the framework.