CR10s Pro V2 artefacts

I have been tuning the settings on my cr10s pro v2 for about a month and having no look, I am currently using esun PLA+ filament and I am always left with these random artefacts. which can been seen in the pic. I have added the latest settings that were tried with Cura, I have been changing retraction distance and speed, as well as flow but other than a bit less after the first attempt it has not seen much improvement. Any help would be much appreciated as I'm now stuck on what to try next.