Thanks for confirming!
Sound quality greatly depends on your headset model. The best this patchset could offer is a FastStream bidirectional codec with very limited hardware support. mSBC or aptX LL are not supported and likely never will be in pulseaudio.
https://btcodecs.valdikss.org.ru/codec-compatibility/ has a list of supported codecs for some devices and links to a very good summary of bluetooth audio, if you are curious.
No, that’s no longer necessary. I found that bluetooth access in Fedora is allowed to all users and updated config to do the same for hsphfpd