Over a bowl, gently squeeze the sausage meat from the sausage casing. Discard the sausage casings.
Use your hands to roll the sausage meat into small meatballs. Alternatively, the sausage meat can be roughly crumbled into small pieces.
Place the pasta into a pot of boiling, salted water and cook according to the packet instructions, until al dente.
While the pasta is cooking, heat a large frying pan over low heat. Cook the onion, garlic and olive oil for 1-2 minutes, stirring, until soft and fragrant.
Increase the heat to medium-high and add the sausage meatballs. Cook for 2-3 minutes, turning, until they are browned on all sides. Add the capsicum and stir.
Add the paprika, garlic powder, onion powder, oregano, cayenne and thyme and stir.
Add the tomato paste, canned tomatoes and stock and stir to combine. Bring to a low simmer and simmer for 5 minutes.
Turn the heat off. Carefully add the cooking cream and grated cheese and stir for 1-2 minutes, until the cheese has mostly melted.
Add the spinach leaves, stirring until the leaves have wilted.
When the pasta is al dente, drain it and add it to the pasta sauce. Stir to combine and allow everything to sit in the pan for 1-2 minutes while the sauce continues to thicken.
Top with some more freshly grated pecorino cheese and serve while hot.