That sounds like a start-up idea. A network of vetted employees doing runs around the city taking care of elderly people. I'd expect their employees would be way happier than the average startup employee, it's meaningful work.

Not really startupy, it's a franchised business [1]. There's not a whole lot to innovate here, unless you're going to match up unsuspecting elders with unlicensed, unscheduled local care givers through an app.

[1] https://www.livingassistance.com/

What may be startup like is that they did kind of pivot : initial service (and whole enrollment process) was targeted to the children who wanted care for their parents. When first elders came to the post office wanting to subscribe for themselves, subscribing was not possible as you can only subscribe for your relatives ... they since modified the service to address these very customers needs

For a startup you could also do just reputation, of caregiver personnel or local caregiving companies.