Hey im curretly using this
#showtooltip
/cast [@mouseover,help,nodead][@target,help,nodead][@player][] Cleanse Toxins
to cast at mouseover and then to act normally if not mousing over and that part works, is there any way to add and mod:ctrl@focus in there aswell to cast on focus target? I cant seem to get it to work. Any help would be greatly appreciated 
#showtooltip
/cast [mod:ctrl,spec:1,@focus,help,nodead] [mod:alt,spec:1,@player] [spec:1,@mouseover,help,nodead] [spec:1] Cleanse; [mod:ctrl,@focus,help,nodead] [mod:alt,@player] [@mouseover,help,nodead] [] Cleanse Toxins
Make sure you have Interface > Combat > Auto self cast enabled.
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You sir are a complete champion, tyvm buddy