We have been bold enough to organize care in a different way. Our choices are always carefully considered. We believe that they contribute to the attainment of our ambition to make care more personal, more affordable and more pleasant. We also believe that full transparency can only make us stronger.
The ‘Platform for Transparency’ brings together information about De Drie Notenboomen as a franchising organization, the various franchise formulas we offer, the choices we make, and the resources we use. Our aim is to demonstrate how our organization works and the implications this has for our stakeholders and society at large.
De Drie Notenboomen in brief
De Drie Notenboomen (DDN) is the leading franchising organization in the Dutch care sector, specializing in small-scale residential care facilities. DDN was founded by Hans van Putten in 2003 and was acquired outright by Loek Winter in 2017.
Our mission is to make healthcare services more personal, more affordable and more pleasant. To this end, DDN has developed four franchise formulas for small-scale residential care facilities catering to various target groups. Each formula focuses on allowing residents to live as normal a life as possible in pleasant surroundings.
Organizational structure and financing
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 Inez Frencken and Roger Lof. 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 2019, 2020 and 2021 are shown here.
Quality of the business organization
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.
Quality of the franchise formulas
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.
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.
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.
De Drie Notenboomen in figures
(Source: De Drie Notenboomen Annual Reports / ARGO)
Real estate and De Drie Notenboomen
Not in ownership
At the inception of De Drie Notenboomen and during the creation of the first Thomashuizen, the organization took the conscious decision to avoid acquiring its own real estate. Although buildings are an essential part of our formulas, DDN does not wish to own bricks and mortar. This is not part of our core business. DDN’s expertise is in facilitating care professionals. This, together with the real estate expertise of third parties, creates a unique combination.
In the Netherlands, we have opted to work closely with housing corporations since they, like DDN, have a social remit. Our collaboration allows the development of appropriate and attractive premises with rents considerably below commercial market rates. This helps to ensure that the cost of residential care remains affordable for all.
To date, 166 locations have been created in association with 31 housing corporations and two private (socially motivated) investors Van Ginkel & Stadsherstel. Our partnerships are long-term in nature (10 to 20 years) and formalized by means of rental agreements. The DDN real estate team supports the housing corporations in the realization and ongoing maintenance of buildings. Maintenance is subject to the standard division of responsibilities between landlord and tenant. When extending a rental agreement, DDN negotiates with regard to the investments required to ensure that the housing concept will remain up to date throughout the term of the lease.
Stichting Onroerend Goed DDN
The Stichting Onroerend Goed DDN exists to:
- Safeguard the continuity of the real estate and the financial position of the residential care concepts developed by De Drie Notenboomen, i.e. Thomashuis, Herbergier, Zorgbutler and Thomas Op Kamers, as well as any concepts to be added to the portfolio in future.
- Offer affordable accommodation to the small-scale residential care concepts facilitated by De Drie Notenboomen.
- Promote the interests of public housing in general, and special accommodation for persons with a care requirement in particular, and all matters which can reasonably be deemed to be relevant to the foregoing.