Add your sausage. Use your spoon to break it up as it cooks. Allow it to brown until fully cooked.
Add your onion. Sauté the onion until it's translucent.
Add your seasonings and Worcestershire sauce. Stir to combine.
Add the water and heavy cream and stir. Let it cook until the gravy thickens, 5-8 minutes.
Taste for salt and pepper.
Serve and enjoy!
Video
Notes
If you want a thicker gravy mix together one tbsp of cornstarch with one tbsp of water to form a slurry. Pour the slurry mixture into the gravy and stir until it has thickened.